• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.15-19
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• 1998

Objectives: It is expected that the combined cisplatin and radiation therapy for nasopharyngeal carcinoma produces more sensory neural hearing losses compared to radiation therapy alone. The purpose of this study was to evaluate the incidence of sensory neural hearing losses after concurrent cisplatin and radiation therapy for nasopharyngeal carcinoma. Materials and Methods: From Jun. 1994 to Mar. 1997, 10 patients were available for this study with the following eligibility criteria: 1) The patients received concurrent cisplatin and radiation therapy for nasopharyngeal carcinoma. 2) There was no pre-existing auditory disease except serous otitis media due to nasopharyngeal carcinoma. 3) They had normal sensorineural hearing function on the pretreatment pure tone audiogram. 4) Pure tone audiograms were performed at least one time after treatment between 6months to 1 year follow-up without local recurrence. Results: At 1 year follow-up, 3 patients complained of decreased hearing capacity. Sensorineural hearing losses were developed in 15 ears out of 20(75%) and were more frequent and severe in high frequency area on pure tone audiogram. Conclusion: The concurrent cisplatin and radiation therapy for nasopharyngeal carcinoma may produce sensorineural hearing losses more frequently compared to historical data of radiation therapy alone and close evaluations with regular audiograms are necessary even in patients without symptoms and signs of hearing impairment.

• The Journal of Internal Korean Medicine
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• v.40 no.6
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• pp.1081-1100
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• 2019

Objectives: This study is an overview of the meta-analysis and systematic review of randomized controlled trials investigating the clinical effectiveness and safety of pharmacopuncture for patients with stroke. Methods: Core electronic databases were searched from their inception to 21 May 2019. A measurement tool to assess systematic reviews (AMSTAR 2) was applied to screen high-quality studies. The results of these studies were summarized, and additional meta-analysis was conducted. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the certainty of evidence. Results: Sixteen studies met eligibility criteria. Four were excluded owing to insufficiency of AMSTAR 2 or low data reliability. The finally selected 12 studies were about pharmacopuncture using either a single herb extract, such as Dengzhan xixin, Sanch, Ginkgo biloba, or Acanthopanax, or a mixture of herbs, such as Compound danshen, Shenxiong, Xingnaojing, or Mailuoning. Most of the patients were from China, with acute ischemic stroke. All the studies using a pharmacopuncture versus a non-pharmacopuncture design reported the significant superiority of pharmacopuncture on every outcome measure. On the other hand, in a few studies, pharmacopuncture was inferior to active control in improving neurological deficit. Few studies reported adverse events. Conclusions: It is difficult to apply the results of this study directly to Korea, because the level of evidence is generally low and the clinical settings and social acceptance of pharmacopuncture therapy differ in Korea and China. Further studies are warranted to confirm the domestic applicability of evidence generated in China and to create evidence that supports the domestic situation.

• Korean Journal of Clinical Pharmacy
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• v.24 no.1
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• pp.1-8
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• 2014

Objective: Currently, rivaroxaban is widely used clinically for thromboprophylaxis after surgery. However, there are concerns on effectiveness and safety of rivaroxaban for its proper use. We aimed to evaluate the effectiveness and safety of rivaroxaban in orthopaedic patients after total hip replacement surgery in a large medical centre after the preferred formulary was switched from enoxaparin to rivaroxaban. Methods: The study was conducted on the patients who underwent hip arthroplasty surgery at the department of Orthopaedic Surgery at Seoul St. Mary's Hospital, South Korea. Electronic medical records were retrospectively reviewed to identify patients treated with rivaroxaban following total hip replacement between February 2011 and March 2012. Evaluation criteria included indications for use, dose, initiation and duration of therapy, drug interactions, adverse reactions, and status of health care reimbursement. The patients who were on enoxaparin were also reviewed as a reference. Results: We identified 57 patients who received rivaroxaban and 50 who received enoxaparin. All patients were prescribed the drugs for Korean Food and Drug Administration-approved indications. No thromboembolic or bleeding events were observed in either group. However, only 5.3% of rivaroxaban- treated patients had an appropriate length of prophylaxis and only 3.5% began rivaroxaban treatment at the recommended time. Surprisingly, 47.4% of rivaroxaban-treated patients received rivaroxaban despite being ineligible for reimbursement benefits. Conclusion: Rivaroxaban was generally well tolerated clinically. However, the duration of treatment, the time of initiation and patient eligibility for reimbursement require improvements, emphasising the need for education which indicates the area of pharmacists' involvement.

• Korean Journal of Clinical Pharmacy
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• v.28 no.3
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• pp.188-193
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• 2018

Background: Previous studies have noted that the simultaneous use of sulfonylureas and antimicrobials, which is common, could increase the risk of hypoglycemia. In particular, an age of 65 years or older is a known risk factor for sulfonylurea-related hypoglycemia in hospitalized patients. Therefore, we performed this study to determine the potential risk of hypoglycemia from the concurrent use of antimicrobials and sulfonylureas. Methods: We performed a cross-sectional study on the National Health Insurance Service-National Sample Cohort from 2013. The eligibility criteria included patients of 65 years of age or older taking a sulfonylurea with 25 different antimicrobials. Different risk ratings of severity in drug-drug interactions (potential DDIs), level X, D, or C in Lexi-$Interact^{TM}$ online, and contraindicated, major, or moderate severity level in $Micromedex^{(R)}$ were included. SAS version 9.4 was used for data analysis. Results: A total of 6,006 elderly patients with 25,613 prescriptions were included. The largest age group was 70 to 74 (32.7%), and 39.7% of patients were men. The mean number of prescriptions was 4.3 per patient. The most frequently used antimicrobials were levofloxacin (6,583, 25.7%), ofloxacin (6,549, 25.6%), fluconazole (4,678, 18.0%), and ciprofloxacin (2,551, 9.8%). Among sulfonylureas, glimepiride was prescribed most frequently, followed by gliclazide, glibenclamide, and glipizide. Conclusion: Of the antimicrobials with a high potential of hypoglycemia, levofloxacin, ofloxacin, fluconazole, and ciprofloxacin were used frequently. Thus, the monitoring of clinically relevant interactions is required for patients concurrently administered sulfonylureas and antimicrobials.

• Research in Community and Public Health Nursing
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• v.27 no.2
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• pp.183-192
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• 2016

Purpose: The purpose of this study was to seek the direction of community health nursing practice education focus on the nursing education accreditation criteria. Methods: We collected data through e-mail survey to all of 202 Korean nursing baccalaureate education institute in April, 2016. The 93 professors teaching community health nursing was responded about their affiliated institute (response rate 46.0%). Results: The Korean nursing graduates in Feb. 2016 was practiced 3.01 credits, 131.6 hours in community health nursing course. Community health nursing practice agency was public health center (98.9%), Public health center post (43.0%), Public health center branch (32.3%) in order. The possibility to achieve the course objectives up to national examination was recognised Public health center (3.4), Public health center post (3.3), Public health center branch and school (3.2) from 5 score likert scale. A lot of nursing education institute have difficulty in clinical placement in community health nursing practice agency that meet eligibility of preceptor and space gaining for only nursing students. Conclusion: The nursing education accreditation criteria in 3rd cycle have to be considered real community health nursing practice situation and newly emerging community health nursing fields.

• Journal of Arbitration Studies
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• v.8 no.1
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• pp.221-241
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• 1998

Though the arbitration agreement is a means to resolve disputes autonomously in essence, the Principle of Parties Autonomy and the Principle of Free Contracting can not be applied infinitely without any limitations but subject to the Public Policy and the Compulsory Provisions as established by an interested country. Such principle of law is applied to international arbitration agreements as well, but their validity should be determined by different standards from those in domestic arbitration agreements, in consideration of their internationality. The essential effect of arbitration agreement is to exclude from the jurisdiction of State courts. Depending upon definition of the legal nature of arbitration agreement, the range and contents of the effect of such agreement will vary. Whether State courts can intervene in claims related to Compulsory Provisions is an issue at the level of legislation policy which can not be easily concluded. But, the applicability of Compulsory Provisions can not serve as an imperative ground to deny the eligibility of claims for arbitration, so far as such claims can be disposed of by the parties. On the other hand, it is reasonable to view the arbitration agreement as a substantive contract in its legal nature enabling the authority for dispute resolution to be delegated to arbitrator, so that the Principle of Parties Autonomy can be widely applied throughout the arbitration procedure as well as with other legal acts on private laws. With this, the parties can enjoy an arbitration award appropriate for characteristics of a specific arbitration agreement, thus resulting in facilitating the use of arbitration procedure for international trade activities. To conclude, the Public Policy and the Compulsory Provisions as limitations on arbitration agreement should be applied to such an extent that they can protect States basic moral faith and social order.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.4
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• pp.423-432
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• 2014

Purpose: This study was done to evaluate effectiveness of deep breathing exercise as a postoperative intervention to prevent pulmonary complications. Methods: A search of databases from 1990 to 2012 was done including MEDLINE, EMBASE, CINAHL, Cochrane Library and eight Korean databases. Ten studies met eligibility criteria. Researchers trained in systematic review, independently assessed the methodological quality of selected studies using the Cochrane's risk of bias tool. Data were analyzed using RevMan 5.2 program. Results: Among ten RCTs in four studies, deep breathing exercise was compared with an instrument using interventions such as incentive spirometry, in the other four studies deep breathing exercise was compared with non-intervention, and in last two studies bundles of interventions including coughing and early ambulation were assessed. A significant difference was found between deep breathing exercise group and non-intervention group. The odds ratio (OR) of occurrence of pulmonary complications for deep breathing exercise versus non-intervention was 0.30. However, there was no significant difference between deep breathing exercise group and incentive spirometry group (OR=1.22). Conclusion: Deep breathing exercise is vital to improving cost-effectiveness and efficiency of patient care in preventing postoperative pulmonary complications. For evidence-based nursing, standardized guidelines for deep breathing in postoperative care should be further studied.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5233-5235
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• 2015

Breast cancer is the most common cancer among women in Malaysia. Therefore, it is highly important for the public to be educated on breast cancer and to know the steps to detect it early on. Healthcare providers are in the prime position to provide such education to the public due to their high knowledge regarding health and their roles in healthcare. The present systematic review involved studies conducted in recent years to analyze the knowledge, attitudes and behavior of Malaysian healthcare providers regarding breast cancer, in attempts to obtain an overall picture of how well equipped our healthcare providers are to provide optimal breast cancer education, and to see their perceptions and actual involvement in said education. The systematic review was conducted via a primary search of various databases and journal websites, and a secondary search of references used by eligible studies. Criteria for eligibility included being published from the year 2008 till present, being conducted in Malaysia, and being written in the English language. A total of two studies were eligible for this review. Findings show that Malaysian future and current healthcare providers have moderate knowledge on breast cancer, have a positive towards involvement of breast cancer education, but have poor actual involvement.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.6085-6088
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• 2013

Prostate specidic antigen (PSA) and digital rectal examination (DRE) are the known predictive factors for positive prostate biopsies differing according to the age, region and race. There have been only very limited studies about the impact of PSA on histological findings at prostate biopsy in Turkey. The aim of this study was to evaluate the impact of PSA and clinical stage on histologic findings of prostate biopsy in men older than 75 years of age as a first study in the Turkish population. A total of 1,645 consecutive prostate biopsies were included, with 194 men aged 75 or older. Cancer was identified in 104 patients (53.6%). Of the 104 positive biopsies, Gleason scores were less than 7 in 53 (49%) patients, 7 or greater in 51 (51%) patients. Positive prostate biopsies were significantly correlated with advanced age (p=0.0001), abnormal DRE (p=0.0001) and raised PSA (p=0.0001). The prostate volume was significantly correlated with advanced age especially in prostate cancer patients over 75 years, compared with those under 75 (p=0.0001). These results are useful for counseling men older than 75 years for prostate cancer detection. However, PCa screening decisions are currently based on urologist judgment and detection of latent asymptomatic disease is an important concern regarding costs, overdiagnosis, overtreatment and quality of life (QOL) for men aged 75 years and older. Healthy old patients with a long life expectancy need to be carefully evaluated for eligibility for PCa screening.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.14 no.2
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• pp.15-28
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• 2019

Objectives : This study aimed to systematically and comprehensively review controlled clinical trials on the effectiveness and safety of Chuna Manual Therapy for stroke. Methods : By October 7, 2019, three core databases and three domestic databases were searched. Seven major academic journals on the related field were also hand-searched. Methodological quality of the included studies was evaluated using the Cochrane risk of bias tool. Meta-analysis was conducted and the quality of its evidence was assessed using the GRADE methodology. Results : Five articles met the eligibility criteria. The results of most of included studies were in favor of Chuna Manual Therapy. No study described any adverse events during or after the clinical trials. Meta-analysis of three eligible studies showed that the pre- and post-treatment scores on the Modified Barthel Index (mean difference 8.00, 95% confidence interval 0.26 to 15.74) and Berg Balance Scale (mean difference 3.57, 95% confidence interval 0.64 to 6.51) of the Chuna-treated group were significantly different, but only marginally higher than those of the non-treatment group. Thus, the level of evidence gathered from these studies was assessed to be low. Conclusions : Based on current available evidence, any confirmative conclusions cannot be made on the effectiveness and safety of Chuna Manual Therapy for stroke because of the small sample size, low methodological quality, presence of statistical heterogeneity, and missing safety information. More rigorously designed large-scale multi-center studies are needed to establish more specific and credible evidence to support or oppose the use of Chuna Manual Therapy for stroke.