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Inter-observer Reliability of Indicators and Decision of Pattern Identification Using Diagnostic Flowchart with Traditional korean Medicine

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Chinese Journal of Integrative Medicine 2017年第5期23卷 338-344页

作者： Ju Ah Lee Jeeyoun Jung mi mi ko Myeong Soo Lee korean Medicine Fundamental Research Division Korea Institute of Oriental Medicine Daejeon 305-811 Republic of Korea Clinical Research Division Korea Institute of Oriental Medicine Daejeon 305-811 Republic of Korea

Objective： To evaluate the consistency of patterns and pattern identification（PI）, and the improvement in the diagnosis of blood stasis after the standard operating procedures（SOPs） were enhanced by using a diagnostic flowchart. Methods： A total of 358 subjects who were admitted by the Jaseng Hospital of korean Medicine between June 2013 and December 2014 were included in the study. Each patient was independently diagnosed by two experts from the same department. In 2014, the SOPs included the use of a diagnostic flowchart for each indicator. Inter-observer consistency was assessed by simple percent agreement and by the kappa and AC1 statistics. Results： The improvements in inter-observer agreement for the indicators（for al patients） and PI were greater in 2014 than in 2013. In 2013, the j-value measure of agreement between the two experts ranged from ＂poor＂（κ=–0.051） to ＂good＂（κ=0.968）. The AC1 measure of agreement between the experts was generally high for the indicators and ranged from –0.010 to 0.978. In most cases, agreement was considerably lower when it was assessed by the j-values compared with the AC1 values. In 2014, the j-value measure of agreement on the indicators（for the subjects） general y ranged from poor to good, with the values ranging from –0.007 to 0.994. Moreover, the AC1 measure of agreement between the experts was general y high for al of the indicators and ranged from ＂moderate＂（AC1=0.408） to ＂excel ent＂（AC1=0.996）. Conclusions： In four examinations, there was moderate agreement between the clinicians on the PI indicators of blood stasis. To improve clinician consistency（e.g., in the diagnostic criteria used）, it is necessary to analyse the reasons for inconsistency and to improve clinician training.（Trial registration No. KCT0000916）

关键词： blood stasis inter-observer reliability pattern identification traditional Chinese medicine traditional korean medicine

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Recognition of Association Between Blood Stasis Syndrome and Traumatic Injury among Doctors of korean Medicine:A Cross-Sectional Observation Study

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Chinese Journal of Integrative Medicine 2018年第4期24卷 254-259页

作者： Jeeyoun Jung mi mi ko Ju Ah Lee Myeong Soo Lee korean Medicine Fundamental Research Division Korea Institute of Oriental Medicine Clinical Research Division Korea Institute of Oriental Medicine

Objective： To investigate the diagnostic indicators and herbal treatments for blood stasis syndrome（BSS） patients with traumatic injuries and to identify the association between BSS and traumatic injury in korea. Methods： Two-hundred and four patients with traumatic injury were recruited from the Gangnam and Daejeon branches of Jaseng Hospital of Oriental Medicine between June 2014 and December 2014. Two independent doctors of korean medicine（DKMs） determined the diagnosis of BSS or non-BSS based on the subjects＇ signs and symptoms. The scores assigned to BSS symptoms and DKMs＇ reasons for diagnosing BSS in patients with traumatic injury were investigated. Both medication and herbal prescription records from a 3-month period were collected for all patients diagnosed with BSS by both DKMs. Results： A total of 169 of 204（82.8%） patients received consistent diagnosis related to BSS by two DKMs. Among them, 54.4%（92 cases） were diagnosed with BSS, and 45.6%（77 cases） were not diagnosed with BSS. DKMs most frequently cited symptoms of recent traumatic injury as justifications for BSS diagnoses, and also selected pain-related indicators such as abdominal pain, sharp pain and nocturnal pain as important reasons in diagnosing BSS. In addition, an inconsistency in the pattern identification theory with respect to traumatic injury was observed. Although only 92 cases（54.4%） of patients were diagnosed with BSS, 77.6% of them were prescribed decoctions for BSS. Conclusions： DKMs considered traumatic injury could cause BSS, and utilized decoction for BSS in patients with traumatic injury without confirming a diagnosis of BSS because they assumed the main symptoms or pathologies of traumatic injury to be closely related to BSS.

关键词： blood stasis syndrome korean medicine traumatic injury herbal medicine diagnosis pattern identification

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Diagnostic Indicators for Blood Stasis Syndrome Patients with Gynaecological Diseases

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Chinese Journal of Integrative Medicine 2018年第10期24卷 752-757页

作者： Jeeyoun Jung mi mi ko Myeong Soo Lee So min Lee Ju Ah Lee korea Medicine Fundamental Research Division Korea Institute of Oriental Medicine Clinical Research Division Korea Institute of Oriental Medicine

Objective： To investigate the important diagnostic indicators for blood stasis syndrome （BSS） in patients of childbearing age with gynaecological diseases. Methods： A partial least squared-discriminant analysis （PLS-DA） were applied to BSS symptoms data of patients with gynaecological diseases, and the diagnostic indicators used by doctors of korean medicine （DKMs） among BSS patients with gynaecological diseases were also investigated. Results： A total of 103 patients of childbearing age with gynaecological diseases and 40 healthy controls were enrolled. Among the 103 patients, 63 （61.7%） and 40 （38.8%） were diagnosed with BSS and non-BSS, respectively, and BSS patients exhibited a more severe extent of disease. A score plot of PLS-DA showed clearly different patterns among the 3 groups. Based on the variable importance on projection of PLS-DA model, menstrual pains, dark lumps in the menstrual blood, ileocoecal tenderness and resistance, sharp pains, and sublingual varicosities were selected as the top five most important indicators. Moreover, more than 75% of DKMs chose dark lumps in menstrual blood, menstrual pain, and dark menstrual blood as the diagnostic indicators of BSS in patients with gynaecological diseases, and more than 49% of them also considered sharp pains, dark red tongue, sublingual varicosities, and tendency to bruise easily as diagnostic indicators of BSS. Conclusion： DKMs focused on menstrual symptoms and certain gynaecological symptoms to diagnose BSS patients of childbearing age with female diseases.

关键词： blood stasis syndrome diagnosis gynaecological disease pattern identification

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A case of a duodenal duplication cyst presenting as melena

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World Journal of Gastroenterology 2013年第38期19卷 6490-6493页

作者： Seung Yeon ko Sun Hye ko Sungeun Ha mi Sung Kim Hyang mi Shin Myong Ki Baeg Department of General Surgery College of MedicineThe Catholic University of Korea Department of Internal Medicine College of MedicineThe Catholic University of Korea Department of Pathology College of MedicineThe Catholic University of Korea

Duodenal duplication cysts are benign rare congenital anomalies reported mainly in the pediatric population,but seldom in *** depend on the type and location and can present as abdominal pain,distension,dysphagia or *** have been reported to be responsible for duodenal obstruction,pancreatitis and,in rare cases,gastrointestinal *** present a case of a duodenal duplication cyst in a 43-year-old man presenting as *** gastroduodenoscopy and colonoscopy did not reveal any bleeding ***,the patient began passing melena after 3 d,with an acute decrease in hemoglobin *** studies revealed a duplication cyst in the second portion of the duodenum which was surgically *** revealed a duodenal duplication cyst consisting of intestinal *** was no further bleeding and the patient recovered *** rare cases,duodenal duplication cysts might cause gastrointestinal bleeding and should be included in the differential diagnosis.

关键词： Gastrointestinal hemorrhage Duodenum Duplication

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Active case-finding for tuberculosis by mobile teams in Myanmar:yield and treatment outcomes

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Infectious Diseases of Poverty 2017年第1期6卷 683-690页

作者： Ohnmar Myint Saw Saw Petros Isaakidis Mohammed Khogali Anthony Reid Nguyen Binh Hoa Thi Thi Kyaw ko ko Zaw Tin mi mi Khaing Si Thu Aung National Tuberculosis Programme Corner of Mingyi Road and Minglar StreetPathein townshipAyeyarwaddy RegionMyanmar Department of Medical Research YangonMyanmar Medecins sans Frontieres Operational Research UnitLuxembourgLuxembourg National Tuberculosis Programme HanoiVietnam Centre for Operational Research International Union Against Tuberculosis and Lung DiseaseParisFrance TB Unit WHO Country Office for MyanmarYangonMyanmar

Background:Since 2005,the Myanmar National Tuberculosis Programme(NTP)has been implementing active case finding(ACF)activities involving mobile teams in hard-to-reach *** study revealed the contribution of mobile team activities to total tuberculosis(TB)case detection,characteristics of TB patients detected by mobile teams and their treatment ***:This was a descriptive study using routine programme data between October 2014 and December *** team activities were a one-stop service and included portable digital chest radiography(CXR)and microscopy of two sputum *** algorithm of the case detection included screening patients by symptoms,then by CXR followed by sputum microscopy for *** patients were started on treatment and followed until a final outcome was ***:A total of 9349 people with symptoms suggestive of TB were screened by CXR,with an uptake of 96.6%.Of those who were meant to undergo sputum smear microscopy,51.4%had sputum ***,504 TB patients were identified by the mobile teams and the overall contribution to total TB case detection in the respective townships was 25.3%.Among total cases examined by microscopy,6.4%were sputum smear positive *** success rate was high as 91.8%in study townships compared to national rate 85%(2014 cohort).Conclusions:This study confirmed the feasibility and acceptability of ACF by mobile teams in hard-to-reach contexts,especially when equipped with portable,digital CXR machines that provided immediate ***,the follow-up process of sputum examination created a significant barrier to confirmation of the *** order to optimize the ACF through mobile team activity,future ACF activities were needed to be strengthened one stop service including molecular diagnostics or provision of sputum cups to all presumptive TB cases prior to CXR and testing if CXR suggestive of TB.

关键词： Mobile team Active case finding Chest X-ray Treatment outcomes

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Adolescents’ Estimation of Energy Content of Standard Portion Size of Foods and Its Association with Body Mass Index

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Food and Nutrition Sciences 2012年第10期3卷 1340-1348页

作者： mi-Kyeong Choi min-Jung ko mi-Hyun Kim Department of Food and Nutrition Kangwon National University Gangwon Samcheok 245-711 Korea Deptartment of Food and Nutrition Kongju National University Chungnam Kongju 340-742 Korea

The purpose of this study is to identify the adolescents’ knowledge of the energy content of the standard portion size of foods and to investigate the association between their knowledge and energy intake and also body mass index (Bmi). A total of 251 middle school adolescents participated in this study. Participants’ knowledge was assessed based on their estimation of the energy content of the standard portion size of foods. To estimate the energy intake of the subjects, 24-hr recall was used. The percentage of participants who accurately estimated (that is within 20% of the true value) the energy content of the standard portion size was calculated for each of the 32 typical foods. The food for which the most participants revealed the accurate estimation was cooked rice (39.5%). The proportion of students who overestimated the energy contents was highest for vegetables (98%), and oils and sugar (90%). The female students were more likely than males to provide the accurate estimation of energy contents for standard portion size of foods. After adjusting for age and sex, the estimation level ([estimation value/true value] × 100) of the energy content of some foods had a significant positive relationship with Bmi, but had no significant relationship with reported energy intake. From these results, we concluded that the knowledge of energy content of food was poor among middle-school adolescents, with some gender difference, and that their estimation of the calorie contents of foods increased along with their Bmi.

关键词： Knowledge of Energy Content Portion Size Energy Intake Bmi Adolescents

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Formulation of a film-coated dutasteride tablet bioequivalent to a soft gelatin capsule(Avodart~?): Effect of γ-cyclodextrin and solubilizers

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Asian Journal of Pharmaceutical Sciences 2019年第3期14卷 313-320页

作者： mi-Hong min Jin-Hyong Park mi-Ran Choi Jong-Hyun Hur Byung-Nak Ahn Dae-Duk Kim College of Pharmacy and Research Institute of Pharmaceutical Sciences Seoul National UniversitySeoul08826Republic of Korea Central Research Institute Whanin Pharmaceutical Company4FGBSA107Gwanggyo-roYeongtong-guSuwon16229Republic of Korea

The aim of this study was to optimize a tablet formulation of dutasteride that is bioequivalent to a commercially available soft gelatin capsule(Avodart~?). The effect of cyclodextrin on enhancing the aqueous solubility of dutasteride was investigated, after which the formulation was further optimized with solubilizing polymer and surfactant. Among the cyclodextrins tested, the highest solubility was observed when dutasteride was complexed with γ-cyclodextrin. Moreover, the addition of polyvinylpyrrolidone and Gelucire/TPGS further enhanced the solubility of dutasteride. Differential scanning calorimetry(DSC) and powder X-ray diffraction(pX RD) studies demonstrated that dutasteride existed in the amorphous form in the complex. Optimized dutasteride complexes were selected after a pharmacokinetic study in rats, and film-coated tablets were prepared by the direct compression method. In vitro dissolution profiles for the tablets of dutasteride complexes were similar to those of the reference. Moreover, pharmacokinetic parameters including the C max and AUC values after oral administration in beagle dogs were not significantly different from those of the reference with a relative bioavailability of 92.4%. These results suggest the feasibility of developing a tablet formulation of dutasteride using cyclodextrin complex in addition to a solubilizing polymer and surfactant.

关键词： Dutasteride Tablet Cyclodextrin Complex Formulation

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Depression in Adults with Congenital Heart Disease:Prevalence,Prognosis,and Intervention

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Cardiovascular Innovations and Applications 2018年第B5期3卷 97-106页

作者： Jong mi ko Ari M.Cedars Baylor Heart and Vascular Institute Baylor Scott and White Research InstituteDallasTXUSA Department of Cardiology Baylor Scott and White Health CareDallasTXUSA

Data on the prevalence of depression in adult congenital heart disease(ACHD)patients differ *** aim to summarize the best available information on the prevalence of depression,its prognostic impact,and psychiatric interventions for depressed ACHD *** reviewed references in relevant publications up to October 17,*** homogeneity of data,studies in which depression was independently assessed in patients aged 18 years or older or with a mean/median age older than 18 years were *** and postoperative evaluation studies were *** publications met these *** samples included ACHD patients followed up at ACHD-specialized hospitals in 13 *** prevalence of depression differed widely,ranging from 6 to 69%.Depression has been shown to be an independent predictor of adverse clinical *** is also frequently associated with other prognostic variables(i.e.,poor functional class,unfavorable perceived health status,and low quality of life).Currently,no randomized clinical trials on psychiatric interventions in ACHD are *** summary,depression is highly prevalent in ACHD patients,yet it is often unrecognized and *** adverse prognostic impact of depression calls for specialized psychiatric interventions,for which more research is needed in the ACHD patient population.

关键词： depression adult congenital heart disease

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Antioxidative phytoceuticals to ameliorate pancreatitis in animal models: An answer from nature

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World Journal of Gastroenterology 2014年第44期20卷 16570-16581页

作者： Jong-min Park Sooyeon Lee mi Kyung Chung Sung-Hun Kwon Eun-Hee Kim Kwang Hyun ko Chang Il Kwon Ki Baik Hahm CHA Cancer Prevention Research Center CHA University Digestive Disease Center CHA University Bundang Medical Center

Despite enthusiastic efforts directed at elucidating critical underlying mechanisms towards the identification of novel therapeutic targets for severe acute pancreatitis(SAP), the disease remains without a specific therapy to be executed within the first hours to days after onset of symptoms. Although earlier management for SAP should aim to either treat organ failure or reduce infectious complications, the current standard of care for the general management of AP in the first hours to days after onset of symptoms include intravenous fluid replacement, nutritional changes, and the use of analgesics with a close monitoring of vital signs. Furthermore, repeated evaluation of severity is very important, as the condition is particularly unstable in the early stages. In cases where biliary pancreatitis is accompanied by acute cholangitis or in cases where biliary stasis is suspected,an early endoscopic retrograde cholangiopancreatography is ***,practice guidelines regarding the treatment of pancreatitis are *** chronic pancreatitis,conservative management strategies include lifestyle modifications and dietary changes followed by analgesics and pancreatic enzyme ***,attention has been focused on phytoceuticals or antioxidants as agents that could surpass the limitations associated with currently available *** oxidative stress has been shown to play an important role in the pathogenesis of pancreatitis,antioxidants alone or combined with conventional therapy may improve oxidativestress-induced organ *** in phytoceuticals stems from their potential use as simple,accurate tools for pancreatitis prognostication that could replace older and more tedious ***,the use of antioxidative nutrition or phytoceuticals may represent a new direction for clinical research in *** this review article,recent advances in the understanding of the pathogenesis of pancreatitis are discussed and the

关键词： Acute pancreatitis Chronic pancreatitis Severe acute pancreatitis Antioxidants Phytoceuticals

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Neuroprotective Effect of Chunghyuldan(Qing Xue Dan)on Hypoxia-Reoxygenation Induced Damage of Neuroblastoma 2a Cell Lines

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Chinese Journal of Integrative Medicine 2013年第12期19卷 940-944页

作者： Chang-Nam ko In-Seo Park Seong-Uk Park Woo-Sang Jung Sang-Kwan Moon Jung-mi Park Chulhun Kang Ki-Ho Cho Department of Cardiology and Neurology Diseases College of Korean MedicineKyung Hee University Department of Medical Science Graduate School of East-West Medical ScienceKyung Hee University

Objectives： Chunghyuldan （CHD）, a combinatorial drug that has anti-hyperlipidemic and anti inflammatory activities, has been shown to reduce infarct volume in a focal ischemia-reperfusion rat model. To explore the molecular basis of CHD＇s neuroprotective effect, we examined whether CHD shows a cell-protective activity and has a regulatory effect on Bax and/or B-cell leukemia/lymphoma 2 （Bcl-2） expression in mouse neuroblastoma 2a （N2a） cells subjected to hypoxia-reoxygenation （H/R）. Methods： In order to evaluate the effects of CHD on the cytotoxicity induced from hypoxia or H/R condition, lactate dehydrogenase （LDH） assay was performed. To explore whether the suppression of neural damage when pre-treated with CHD is associated with its anti-apoptotic effect, the CHD effect on the expression of Bcl-2 and Bax was analyzed by Western blotting analysis. Results： Cytotoxicity of N2a cell line was slightly increased in 42 h hypoxia condition and dramatically increased under the H/R condition. CHD treatment markedly decreased the cytotoxicity in both conditions （P〈0.01, P〈0.05）. H/R markedly increased the expression of the pro-apoptotic protein, Bax, but slightly increased the expression of the anti-apoptotic protein, Bcl-2, compared with the normoxia or hypoxia group. CHD significantly decreased Bax expression （P〈0.01） and slightly decreased Bcl-2 expression （P〉0.05）, resulted in a reduction of Bax/Bcl-2 ratio in N2a cells subjected to H/R. Conclusion： CHD has neuroprotective effect in N2a cells subjected to H/R, which might be derived at least in part from its ability to decrease the expression of the pro-apoptotic protein, Bax.

关键词： apoptosis stroke Chunghyuldan herbal

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