Publications by authors named "Sunju Park"

65 Publications

Evaluation of Typhoid Conjugate Vaccine Effectiveness in Ghana (TyVEGHA) Using a Cluster-Randomized Controlled Phase IV Trial: Trial Design and Population Baseline Characteristics.

Vaccines (Basel) 2021 Mar 19;9(3). Epub 2021 Mar 19.

International Vaccine Institute, Seoul 08826, Korea.

Typhoid fever remains a significant health problem in sub-Saharan Africa, with incidence rates of >100 cases per 100,000 person-years of observation. Despite the prequalification of safe and effective typhoid conjugate vaccines (TCV), some uncertainties remain around future demand. Real-life effectiveness data, which inform public health programs on the impact of TCVs in reducing typhoid-related mortality and morbidity, from an African setting may help encourage the introduction of TCVs in high-burden settings. Here, we describe a cluster-randomized trial to investigate population-level protection of TYPBAR-TCV, a Vi-polysaccharide conjugated to a tetanus-toxoid protein carrier (Vi-TT) against blood-culture-confirmed typhoid fever, and the synthesis of health economic evidence to inform policy decisions. A total of 80 geographically distinct clusters are delineated within the Agogo district of the Asante Akim region in Ghana. Clusters are randomized to the intervention arm receiving Vi-TT or a control arm receiving the meningococcal A conjugate vaccine. The primary study endpoint is the total protection of Vi-TT against blood-culture-confirmed typhoid fever. Total, direct, and indirect protection are measured as secondary outcomes. Blood-culture-based enhanced surveillance enables the estimation of incidence rates in the intervention and control clusters. Evaluation of the real-world impact of TCVs and evidence synthesis improve the uptake of prequalified/licensed safe and effective typhoid vaccines in public health programs of high burden settings. This trial is registered at the Pan African Clinical Trial Registry, accessible at Pan African Clinical Trials Registry (ID: PACTR202011804563392).
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http://dx.doi.org/10.3390/vaccines9030281DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003794PMC
March 2021

Acupuncture as an adjuvant therapy for management of treatment-related symptoms in breast cancer patients: Systematic review and meta-analysis (PRISMA-compliant).

Medicine (Baltimore) 2020 Dec;99(50):e21820

Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University; 26, Kyungheedae-ro, Hoegi-dong, Dongdaemun-gu, Seoul.

Background: Although randomized controlled trials have revealed the considerable effectiveness of acupuncture in breast cancer patients, there have been no studies exploring current acupuncture research trends for treatment induced various symptoms in breast cancer patients. This review evaluated the effectiveness of acupuncture for treatment-induced symptoms in breast cancer patients.

Methods: We performed a systematic review and meta-analysis of the literature regarding acupuncture to treat symptoms associated with breast cancer therapies. The following databases were searched for relevant RCTs published before June 2018: MEDLINE, EMBASE, the Cochrane Library, AMED, CINAHL, OASIS, CNKI, and CiNii.

Results: Among the 19,483 records identified, 835 articles remained after screening titles and abstracts. A total of 19 RCTs were included in this qualitative synthesis. Among the studies, 8 explored climacteric symptoms, 4 explored pain, 2 explored lymphedemas, 2 explored nausea and vomiting and 3 investigated miscellaneous symptoms.explored miscellaneous symptoms due to cancer treatments. Most of the studies reported that acupuncture can alleviate various symptoms of breast cancer treatment. However, there is a lack of evidence as to whether accupuncture can alleviate chemotherapy associated side effects CONCLUSIONS:: Acupuncture may alleviate the treatment-related symptoms of breast cancer; however, further studies are necessary to obtain conclusive evidence of the effectiveness of acupuncture in treating breast cancer.

Registration Number: CRD42018087813.
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http://dx.doi.org/10.1097/MD.0000000000021820DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7738093PMC
December 2020

Perception on genetic testing in Korean medicine doctors: A mobile-based survey.

Integr Med Res 2021 Jun 12;10(2):100643. Epub 2020 Aug 12.

Intellectual Informatics Team, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.

Background: Currently, genetic testing is widely used to understand individual characteristics. In Korea, genetic testing has been in use, but not actively in Korean Medicine (KM). To examine the perceptions of genetic testing, we performed online survey to Korean Medicine doctors (KMDs).

Methods: The survey was a mobile-based study that was developed by 6 survey specialists based on electronic database search results. The questionnaire consisted of 6 categories: general characteristics of respondents, understanding of genetic testing, demand for using genetic testing, application field and utilization level of genetic testing, limitations of genetic testing, and plans and necessary efforts to begin using genetic testing based on an 11-point Likert scale.

Results: With the response rate of 27.2% (n = 544), 46.9% of respondents answered that they understood the definition and mechanism of genetic testing. About 80% of KMDs responded that they would be willing to use genetic testing results; a notable reason for this was the need for more objective and evidence-based test results. KMDs recognized that genetic testing could not only provide personalized treatment and care, but also help communicate with patients.

Conclusions: This study observed KMDs' perceptions of the potential clinical benefits of genetic testing. We confirmed that development of genetic testing technology, knowledge of their use, and new technology-friendly policies are essential for expanding the genetic testing technology in Korean medicine.
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http://dx.doi.org/10.1016/j.imr.2020.100643DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7581927PMC
June 2021

Effects and safety of intranasal phototherapy for allergic rhinitis: Study protocol for a single-center, randomized, double-blind, parallel, placebo-controlled, investigator-initiated, pilot study.

Medicine (Baltimore) 2020 Jul;99(30):e20835

Department of Ophthalmology, Otolaryngology, and Dermatology, College of Korean Medicine, Woo-Suk University, Jeonju.

Introduction: Allergic rhinitis (AR) is an immunoglobulin E (Ig E)-mediated inflammatory disease. Intranasal phototherapy is a promising treatment modality because it has a profound immunosuppressive effect, but the available evidence of its use for AR is insufficient. Therefore, rigorously designed randomized controlled trials (RCTs) are needed. Our objective is to describe the protocol for a feasibility trial to assess the effects and safety of intranasal phototherapy for the treatment of AR.

Methods And Analysis: This is a study protocol for a single-center, randomized, double-blind, parallel, placebo-controlled, investigator-initiated pilot study. A total of 40 patients with AR will be randomly assigned to the medical device or sham device group in a 1:1 ratio. The participants will receive intranasal phototherapy with a medical or sham device for 20 min 5 times a week for 2 weeks. The primary outcome will be the mean change in the Total Nasal Symptom Score (TNSS) from baseline to 2 weeks. The secondary outcomes will include the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score, Nasal Endoscopy Index, total serum Ig E level, and eosinophil count.

Discussion: The findings of this study will provide the basis for subsequent large-scale definitive RCTs to confirm the effects and safety of intranasal phototherapy for the treatment of nasal symptoms in patients with AR who do not respond well to conventional therapy. This study may assist in the development of noninvasive treatment for patients with AR.

Trial Registration: This study was registered at the Korean National Clinical Trial Registry, Clinical Research Information Service (KCT0003253).
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http://dx.doi.org/10.1097/MD.0000000000020835DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387024PMC
July 2020

The role of Korean Medicine in the post-COVID-19 era: an online panel discussion part 2 - basic research and education.

Integr Med Res 2020 Sep 24;9(3):100488. Epub 2020 Jul 24.

Korean Medicine Convergence Research Information Center, College of Korean Medicine, Kyung Hee University, Seoul, South Korea.

Background: Experiencing difficulties and challenges though COVID-19 pandemic, there are voices that it needs to be discussed to seek direction of basic research and college education of Korean Medicine (KM) so that KM community can play a significant role in the future infectious disease outbreaks.

Methods: This paper summarizes the edited highlights of an online video meeting by Google meet on May 19, 2020, organized by the Korean Medicine Convergence Research Information Center. Five researchers specialized in immunology, microbiology, virology, preventive medicine, and herbology, respectively, presented what KM community should prepare for the future acute infectious disease outbreaks by learning from the previous research on antiviral effect of herbs for coronavirus and the experiences of the present COVID-19 pandemic.

Results: There are a lot of herbs or natural products with potential anti-coronavirus effects reported from in vitro experiments and despite criticism, many clinical trials on traditional herbal medicine for COVID-19 are being conducted. In addition to establishing research evidence, KM community should train and produce public health professionals among Korean Medicine Doctors (KMDs) and official participation in public healthcare system should be ensured in terms of regulation and policy. Newly developed KM treatments can be interpreted by the KM theories and also should be allowed by regulations for KMDs to utilize them.

Conclusion: The present online discussion suggested directions of basic research for acute viral infections diseases utilizing KM and how to enforce relevant education and regulations in the post-COVID-19 era.
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http://dx.doi.org/10.1016/j.imr.2020.100488DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378014PMC
September 2020

Traditional Korean Medicine education in the World.

Integr Med Res 2020 Jun 29;9(2):100410. Epub 2020 Mar 29.

Institute of Korean Medicine Education and Evaluation, Seoul, Republic of Korea.

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http://dx.doi.org/10.1016/j.imr.2020.100410DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260587PMC
June 2020

Cytokines secreted by stromal cells in TNBC microenvironment as potential targets for cancer therapy.

Cancer Biol Ther 2020 06 26;21(6):560-569. Epub 2020 Mar 26.

Department of Pharmaceutical Science, Albany College of Pharmacy and Health Science, Albany, NY, USA.

In triple-negative breast cancer (TNBC), the lack of therapeutic markers and effective targeted therapies result in an incurable metastatic disease associated with a poor prognosis. Crosstalks within the tumor microenvironment (TME), including those between cancer and stromal cells, affect the tumor heterogeneity, growth, and metastasis. Previously, we have demonstrated that IL-6, IL-8, and CCL5 play a significant role in TNBC growth and metastasis. In this study, we performed a systematic analysis of cytokine factors secreted from four stromal components (fibroblasts, macrophages, lymphatic endothelial cells, and blood microvascular endothelial cells) induced by four TNBC cell types. Through bioinformatic analysis, we selected putative candidates of secreted factors from stromal cells, which are involved in EMT activity, cell proliferation, metabolism, and matrisome pathways. Among the candidates, LCN2, GM-CSF, CST3, IL-6, IL-8, and CHI3L1 are ranked highly. Significantly, Lipocalin-2 (LCN2) is upregulated in the crosstalk of stromal cells and four different TNBC cells. We validated the increase of LCN2 secreted from four stromal cells induced by TNBC cells. Using a specific LCN2 antibody, we observed the inhibition of TNBC cell growth and migration. Taken together, these results propose secreted factors as molecular targets to treat TNBC progression via crosstalk with stromal components.
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http://dx.doi.org/10.1080/15384047.2020.1739484DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7515526PMC
June 2020

Accuracy of online health information on amblyopia and strabismus.

J AAPOS 2019 12 11;23(6):341-344. Epub 2019 Oct 11.

Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. Electronic address:

The internet is a major source of health information for patients and parents. The information found online influences patients' and caregivers' understanding of diagnoses and decision making regarding management. We report the results of a survey completed by 4 fellowship-trained pediatric ophthalmologists evaluating the accuracy and clarity of various websites that provide information on amblyopia and strabismus.
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http://dx.doi.org/10.1016/j.jaapos.2019.09.007DOI Listing
December 2019

Acupoint herbal patching for bronchitis: A protocol systematic review of randomized controlled trials.

Medicine (Baltimore) 2019 Jul;98(29):e16368

Department of Preventive Medicine, College of Korean Medicine, Daejeon University, Daejeon.

Background: Acupoint herbal patching (AHP) is widely used for symptom management in patients with acute and chronic bronchitis. The purpose of this protocol review is to evaluate the safety and efficacy of AHP for the treatment of bronchitis.

Methods And Analysis: This protocol of systematic review will be conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P). The databases searched will include PubMed, Embase, CENTRAL, Web of Science, 3 Korean medical databases (OASIS, Korea Med, and KMBASE), and the Chinese database China National Knowledge Infrastructure (CNKI). Randomized controlled trials (RCTs) or quasi-RCTs using AHP for bronchitis will be considered. The selection of the studies, data abstraction, and validations will be performed independently by 3 researchers.

Conclusion: The conclusion of the review will provide evidence that AHP is an effective intervention in patients with bronchitis.

Ethics And Dissemination: As individuals were not involved, ethical approval is not required. Findings will be published in a peer-reviewed journal. This systematic review may inform the treatment of bronchitis patients in clinical practice.

Registration: This systematic review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO). The reference number is CRD42018110380.
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http://dx.doi.org/10.1097/MD.0000000000016368DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708952PMC
July 2019

[Complementary and Alternative Medicine for Breast Cancer Patients: An Overview of Systematic Reviews].

Yakugaku Zasshi 2019 ;139(7):1027-1046

Department of Korean Gynecology, College of Korean Medicine, Kyung Hee University.

The application of systematic review (SR) has been increased rapidly in the field of cancer treatment. Complementary and alternative medicine (CAM) for cancer is no exception. The aim of this review is to evaluate and summarize systematic reviews on the CAM use in breast cancer patients. Search sources were Centre for Reviews and Dissemination (CRD), Cochrane Database of Systematic Reviews (CDSR), and PubMed. In addition, we assessed the quality of SR with the Assessing the Methodological Quality of Systematic Reviews (AMSTAR). This review did not consider control groups and outcomes. Thirty-four SRs met a set of criteria. According to interventions, there were twenty SRs which included yoga, acupuncture, and herbal medicines. Meta-analysis of 19 out of 34 reviews showed the followings: (1) acupuncture had a beneficial effect on the frequency of hot flushes, (2) yoga had a beneficial effect on depression and health-related QOL, (3) mindfulness-based stress reduction (MBSR) had a beneficial effect on anxiety and depression, (4) combination of herbal medicine and chemotherapy synergistically improved clinical outcomes, (5) acupuncture did not show significant effect on the severity of hot flushes and cancer-related pain, (6) yoga was unable to be confirmed as having an effect on cancer-related pain and physical well-being. Given the results of AMSTAR, 9 out of 34 reviews were of high quality and 3 reviews were deemed to be of low quality. In conclusion, since most SRs were at moderate or high quality levels, CAM could be helpful for treating specific symptoms related to breast cancer.
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http://dx.doi.org/10.1248/yakushi.18-00215DOI Listing
September 2019

Pattern identification of lung cancer patients based on body constitution questionnaires (BCQ) and glycoproteomics for precision medicine.

Medicine (Baltimore) 2019 Jun;98(24):e16035

Laboratory of Clinical Biology and Pharmacogenomics, Department of Preventive Medicine, College of Korean Medicine.

Background: The patient's pattern identification has been used for personalized medicine in traditional Korean medicine (TKM) and aims for patient-specific therapy by Korean medical doctors. The pattern identification in this trial will be diagnosed from body constitution questionnaire (BCQ) with a more objective diagnosis of it but this method still needs a more concrete scientific basis. Glycoproteins are well-known to be associated with diseases (especially cancers) so glycoproteomics can be applied to differentiate pattern identification types of lung cancer patients. Thus, for the first time proteomics approach will be applied to the pattern identification by comparing BCQ assessment in order to establish a scientific basis with clinical proteomics for precision medicine.

Methods: This observational trial will at first diagnose the pattern identification types of lung cancer patients with BCQ assessment and then elucidate their relationships with proteomics. Blood samples will be collected before surgery along with clinical information of participants. The patients' pattern identification in TKM will be diagnosed from BCQ assessment. Then, lung cancer patients will be divided and pooled into 3 lung cancer entire (LCE) groups according to their pattern identification types (Xu, Stasis, or Gentleness). Three lung cancer representative (LCR) groups will be selected and pooled from each LCE group by selecting those with the same control factors. The 3 LCE groups and the 3 LCR groups from lung cancer patients will be independently analyzed through the glycoproteomics approach based on the patients' pattern identification. Glycoproteins from the 6 groups will be identified through proteomics approach and then categorized for analysis.

Discussion: This study intends to diagnose pattern identification of patients in TKM with BCQ assessment and proteomics approach. The identification of the glycoproteins in each group will lead to the scientific foundation of personalized medicine in TKM according to patients' pattern identification for lung cancer therapy. We intend to(1) diagnose the pattern identification types of lung cancer patients with BCQ under the framework of TKM;(2) evaluate BCQ assessment with glycoproteomics approach for precision medicine.

Trial Registration: ClinicalTrials.gov NCT03384680. Registered 27 December 2017. Retrospectively registered.
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http://dx.doi.org/10.1097/MD.0000000000016035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587619PMC
June 2019

Exophthalmos in Kearns-Sayre syndrome.

J AAPOS 2019 10 31;23(5):295-297. Epub 2019 May 31.

Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. Electronic address:

Kearns-Sayre syndrome (KSS) is a rare mitochondrial DNA (mtDNA) deletion syndrome that typically presents before 20 years of age and is characterized by chronic progressive external ophthalmoplegia, pigmentary retinopathy, and a combination of cardiac conduction defects, cerebellar ataxia, and elevated cerebrospinal fluid protein levels. The mtDNA defects interfere with oxidative phosphorylation and can affect a number of cellular energy processes in various organs. We report the case of a 15-year-old girl with KSS that was uniquely associated with bilateral, symmetrical exophthalmos.
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http://dx.doi.org/10.1016/j.jaapos.2019.05.005DOI Listing
October 2019

Recent updates on myopia control: preventing progression 1 diopter at a time.

Curr Opin Ophthalmol 2019 Jul;30(4):215-219

Department of Ophthalmology & Visual Sciences, Montefiore Medical Center, Bronx, New York, USA.

Purpose Of Review: Myopia refers to a refractive state of the eye that can predispose to visually significant ocular disease. The prevalence of myopia is increasing worldwide. Researchers internationally have been investigating methods to slow down its progression to prevent sight-threatening complications. In this article, we perform a review of the current literature discussing interventions for preventing pediatric myopic progression.

Recent Findings: Various interventions, including lifestyle modification, optical methods, and pharmacologic approaches, have been proposed to help control myopic progression. Increasing time spent outdoors can help prevent myopia onset, but has a clinically questionable effect on progression of myopia. Contact lenses that reduce peripheral retinal hyperopic defocus represent a new area of research and may hold promise as an effective intervention in myopia control. Orthokeratology shows moderate reduction rates in myopic progression whereas atropine drops, even at low doses, show the most impressive effect on slowing myopia.

Summary: Atropine eye drops, followed by orthokeratology lenses, are the most effective in slowing down axial elongation and myopic progression. Guidelines for use and the target populations for such interventions have not been well established and more research is warranted in these areas. Treatment should be tailored to each patient.
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http://dx.doi.org/10.1097/ICU.0000000000000571DOI Listing
July 2019

Clinical Effectiveness of Traditional and Complementary Medicine Interventions in Combination with Nicotine Replacement Therapy on Smoking Cessation: A Randomized Controlled Pilot Trial.

J Altern Complement Med 2019 May 23;25(5):526-534. Epub 2019 Apr 23.

4 Department of Preventive Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea.

Smoking is associated with many preventable diseases and deaths. Globally, more than 6 million deaths per year are related to smoking. This study aimed to evaluate the pragmatic effectiveness of traditional and complementary medicine (T&CM) interventions for the smoking cessation treatment and to calculate the incremental cost-effectiveness ratio (ICER) of these interventions. The study design was a pragmatic, open-label randomized trial. The hypothesis of this trial was that the smoking cessation success rate increases with the addition of T&CM methods. The intervention group was provided T&CM interventions in addition to nicotine replacement therapy (NRT) and counseling, whereas the control group was treated with only NRT and counseling. Individuals received treatment for 4 weeks, then follow-up care for 20 weeks. Forty-one participants were enrolled and assigned to either an intervention group or a control group at a ratio of 1:1. The odds ratio values at 4 weeks were 1.96 (0.51-8.51) in intention-to-treat analysis and 3.27 (0.75-17.75) in per-protocol analysis. The amount of smoking (cigarettes) decreased in both groups: from 17.2 ± 10.31 (baseline) to 1.7 ± 3.02 (4 weeks) in the intervention group and from 12.9 ± 5.47 (baseline) to 3.3 ± 5.96 (4 weeks) in the control group. The total medical costs per patient were $212.20 USD in the intervention group and $170.80 in the control group. The adjusted ICER of T&CM interventions was $13,355. This pilot study evaluated the clinical feasibility of T&CM used in conjunction with NRT and counseling for the smoking cessation treatment. However, there was no statistically significant effectiveness of T&CM interventions to raise cessation success rate. This study demonstrates the necessity for further studies based on large-scale randomized controlled trials.
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http://dx.doi.org/10.1089/acm.2019.0009DOI Listing
May 2019

Single-dose Intravenous Injection Toxicity of Water-soluble Danggui Pharmacopuncture (WDP) in Sprague-Dawley Rats.

J Pharmacopuncture 2018 Jun 30;21(2):104-111. Epub 2018 Jun 30.

Department of Internal Medicine, College of Korean Medicine, Sangji University, Wonju, Gangwon, Korea.

Objective: This study is to evaluate both the single-dose intravenous injection toxicity and the approximate lethal dose of Water-soluble Danggui Pharmacopuncture (WDP) in Sprague-Dawley (SD) rats.

Methods: Toxicity experiments were conducted at Good Laboratory Practice (GLP) laboratory in Biotoxtech Co., according to the regulations of GLP. WDP injection of dose 0.125, 0.25, and 0.5 mL/animal were experimental groups and normal saline injection group was control group. WDP and normal saline were injected once to 6-week old 5 male and 5 female SD rats at the tail veins at approximately 2 mL/min. During 14 days after the injection, general symptoms were observed and weight were measured. After the observation period, hematological and blood biochemical examination, macroscopic autopsy, topical resistance test at the injection area were performed.

Results: RThe WDP 0.5 mL/animal injection group in 4 cases of male rats and all cases of female rats showed hematuria 30 minutes after the administration. However, after 1 hour, no more abnormal general symptoms were observed. The WDP did not affect weight, hematological and blood biochemical examination, macroscopic autopsy, and topical resistance test at the injection area.

Conclusion: WDP single dose intravenous injection results showed that WDP have no toxic effects and a lethal dose of WDP should be over 0.5 mL/animal in male and female rats under the study condition. So WDP may be safe.
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http://dx.doi.org/10.3831/KPI.2018.21.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6054094PMC
June 2018

An assessment of the use of complementary and alternative medicine by Korean people using an adapted version of the standardized international questionnaire (I-CAM-QK): a cross-sectional study of an internet survey.

BMC Complement Altern Med 2018 Aug 13;18(1):238. Epub 2018 Aug 13.

Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon, 34054, Republic of Korea.

Background: In Korea, there are two types of medical doctors: one practises conventional medicine (hereafter called a physician), and the other practises traditional medicine (hereafter called a Korean medical doctor). This study aimed to compare the provision of complementary and alternative medicine (CAM) by these providers to CAM use per self-judgement in Korea.

Methods: We analysed 1668 Korean people via an internet survey with the Korean adopted version of the I-CAM-Q, namely, the International Questionnaire to measure use of CAM, to understand whether respondents used CAM based either on a prescription or advice from a physician or a Korean medical doctor or on self-judgement.

Results: In the previous 12 months, the proportions of respondents who were treated by a physician, who were treated by a Korean medical doctor and who were not treated by anyone were 67.9, 20.7 and 14.2%, respectively. Among the respondents who received CAM based on a prescription or advice from a physician, traditional Korean medicine practices and dietary supplements were commonly used; only a small percentage used other CAM therapies. Respondents who received CAM based on a prescription or advice from a Korean medical doctor showed similar results. Acupuncture and moxibustion, traditional Korean medicines (decoction), or cupping were more commonly used. Korean traditional medicines as over-the-counter (OTC) drugs were more commonly used by respondents who received CAM therapy based on a prescription or advice from a physician than by those who received CAM therapy based on a prescription or advice from a Korean medical doctor. A total of 74% of the responders used any CAM by self-judgement in the previous 12 months.

Conclusions: For the use of CAM in Korea, in addition to the Korean traditional medical care provided by Korean medical doctors, general physicians advised people regarding Korean traditional medical care and dietary supplements.
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http://dx.doi.org/10.1186/s12906-018-2294-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6090824PMC
August 2018

Traditional Korean medicine treatment for livedoid vasculopathy: Five case reports.

Explore (NY) 2018 09 10;14(5):357-366. Epub 2018 Aug 10.

Department of Preventive Medicine, College of Korean Medicine, Daejeon University, 62 Daehak-ro, Daejeon 34520, Republic of Korea. Electronic address:

Introduction: This study was performed to evaluate the clinical effect of a Korean medicine treatment for livedoid vasculopathy (LV).

Methods: Five patients with LV were selected who exhibited blood stasis due to qi stagnation () caused by external cold () or dual deficiency of qi and blood () and who had suffered from chronic episodic LV for at least 2 years. The treatment consisted of Korean herbal medicine, Haechungtang (, HC). Five cases were evaluated based on visual symptoms. The symptoms at first visit were scored on a visual analogue scale (VAS) from 1 to 10.

Results: Following treatment, all of the symptoms except pigmentation disappeared completely in all cases. No symptom control with corticosteroids or warfarin was necessary.

Conclusion: These case reports suggest that HC could be effective for treating LV. Follow-up studies and further clinical studies are needed to evaluate recurrence and to provide more efficient treatment.
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http://dx.doi.org/10.1016/j.explore.2017.12.008DOI Listing
September 2018

Eunkyosan for treatment of the common cold: A protocol for the systematic review of controlled trials.

Medicine (Baltimore) 2018 May;97(18):e0527

Department of Internal Medicine College of Korean Medicine, Gachon University, Seongnam, Korea Korean Medicine Hospital of Pusan National University, Yangsan Department of Preventive Medicine, College of Korean Medicine, Daejeon University ???.

Introduction: Eunkyosan (EKS) is widely used for common colds in East Asian countries. Many clinical trials assessing the efficacy and safety of EKS formula for the treatment of common colds have been reported. This review will assess the clinical evidence for and against the use of EKS formula as a treatment for common colds.

Methods And Analysis: Fourteen databases will be searched from inception until March 2018. We will include randomized controlled trials (RCTs) assessing EKS decoctions for any type of common cold. All RCTs of decoctions or modified decoctions will be included. The methodological qualities of the RCTs will be assessed using the Cochrane Collaboration tool for assessing risk of bias, while confidence in the cumulative evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument.

Ethics And Dissemination: This systematic review will be published in a peer-reviewed journal and will also be disseminated electronically and in print. The review will be updated to inform and guide healthcare practices.Registration number: CRD42018087694.
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http://dx.doi.org/10.1097/MD.0000000000010527DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392552PMC
May 2018

Characteristics and Outcomes of Female Infertility Treatment Programs Using Traditional Medicine in Korea: A Multisite Analysis.

J Altern Complement Med 2018 Jun 22;24(6):570-577. Epub 2018 Mar 22.

6 Department of Preventive Medicine, College of Korean Medicine , Kyung Hee University, Seoul, Republic of Korea.

Introduction: Infertility has long been recognized as a treatable disease, and complementary and alternative medicine treatments, such as acupuncture and moxibustion, have been used in Korea and China. This study describes female infertility treatment programs that used traditional Korean medicine (TKM) and were conducted by local governments in Korea and evaluates its effectiveness and safety.

Methods: The authors officially requested related information from the report of the infertility treatment programs and related sources from 2006 to 2016 from the Health & Welfare Ministry of Korea and the Association of Korean Medicine (AKOM). Additional information was obtained from six Korean databases. Data including basic information about the programs, participant information, interventions, and outcomes were abstracted.

Results: A total of 9 reports, including multiple years of data from 6 programs (total 13 programs), were identified. In these 13 programs, a total of 1023 female subjects participated, and 205 of the 887 subjects who completed the program reported a successful pregnancy, indicating a 23.1% pregnancy rate. The programs lasted 3-9 months, and interventional elements, such as herbal medicine, acupuncture, fumigation, and massage, were identified. Significant adverse effects were not reported.

Conclusions: This study suggests that infertility treatment programs with TKM interventions exhibited a positive effect on pregnancy in females with infertility. Thus, the infertility treatment programs with TKM interventions are expected to be useful and might serve as the primary treatment before assisted reproduction techniques.
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http://dx.doi.org/10.1089/acm.2016.0384DOI Listing
June 2018

Pigmented Purpuric Dermatosis in Adults Treated with Herbal Medicine: Report of Five Cases.

Explore (NY) 2018 Mar - Apr;14(2):152-160. Epub 2017 Dec 23.

Department of Preventive Medicine, College of Korean Medicine, Daejeon University, 62 Daehak-ro, Daejeon 34520, Republic of Korea. Electronic address:

Background: The purpose of this report is to demonstrate the clinical effect of Korean medicine treatment for pigmented purpuric dermatosis (PPD).

Methods: Five cases of PPD with skin purpura and blood heat due to blood deficiency were evaluated. All patients had been in a chronic disease state for at least 1 year. The treatment consisted only of the Korean herbal medicine Gami-Samultang (GS). The degree of symptoms that the patients experienced when they first visited our clinic was set at a visual analog scale (VAS) score of 10.

Results: After treatment, body purpura disappeared in all cases. In contrast, the patients' symptoms had not resolved following previous steroid treatment. All patients were satisfied with the treatment results and showed a VAS score of 0 for purpura.

Conclusion: This report suggests that GS can be used to effectively treat PPD. Additional clinical studies on PPD are needed to develop more comprehensive treatment guidelines.
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http://dx.doi.org/10.1016/j.explore.2017.04.022DOI Listing
September 2018

Experiences Providing Medical Assistance during the Sewol Ferry Disaster Using Traditional Korean Medicine.

Evid Based Complement Alternat Med 2017 7;2017:3203768. Epub 2017 Nov 7.

Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.

Background: This study aimed to investigate medical records using traditional Korean medicine (TKM) in Sewol Ferry disaster in 2014 and further explore the possible role of traditional medicine in disaster situation.

Methods: After Sewol Ferry accident, 3 on-site tents for TKM assistance by the Association of Korean Medicine (AKOM) in Jindo area were installed. The AKOM mobilized volunteer TKM doctors and assistants and dispatched each on-site tent in three shifts within 24 hours. Anyone could use on-site tent without restriction and TKM treatments including herb medicine were administered individually.

Results: The total of 1,860 patients were treated during the periods except for medical assistance on the barge. Most patients were diagnosed in musculoskeletal diseases (66.4%) and respiratory diseases (7.4%) and circulatory diseases (8.4%) followed. The most frequently used herbal medicines were Shuanghe decoction (80 days), Su He Xiang Wan (288 pills), and Wuji powder (73 days).

Conclusions: TKM in medical assistance can be helpful to rescue worker or group life people in open shelter when national disasters occur. Therefore, it is important to construct a rapid respond system using TKM resources based on experience.
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http://dx.doi.org/10.1155/2017/3203768DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5697367PMC
November 2017

Human HER2 overexpressing mouse breast cancer cell lines derived from MMTV.f.HuHER2 mice: characterization and use in a model of metastatic breast cancer.

Oncotarget 2017 Sep 10;8(40):68071-68082. Epub 2017 Jul 10.

Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA.

Preclinical evaluation of therapeutic agents against metastatic breast cancer require cell lines and animal models that recapitulate clinical metastatic breast cancer as much as possible. We have previously used cell lines derived from the neu-N transgenic model to investigate anti-neu targeting of metastatic breast cancer using an alpha-emitter labeled antibody reactive with the rat variant of HER2/neu expressed by the neu-N model. To investigate alpha-particle emitter targeting of metastatic breast cancer using clinically relevant, commercially available anti-HER2/neu antibodies, we have developed cell lines derived from primary tumors and lung metastases from HuHER2 transgenic mice. We extracted primary mammary gland tumors, isolated the epithelial breast cancer cells, and established seven different cell lines. We also established 2 different cell lines from spontaneous lung metastases and cell lines from a serial transplantation of tumor tissues in HuHER2 transgenic mice. HuHER2 protein was overexpressed in all of the established cell lines. The mRNA level of ER (estrogen receptor) and PR (progesterone receptor) was relatively low in the cell lines compared to normal mammary gland (MG). As EMT markers, the expression of E-Cadherin in the cell lines was downregulated while the expression of TWIST1 and Vimentin were upregulated, relative to MG. Furthermore, trastuzumab directly inhibited cellular viability. Biodistribution studies with In-DTPA-trastuzumab in HuHER2 cell tumor xenografts demonstrated specific targeting with a clinically relevant antibody. Collectively, these cell lines show all the hallmarks of highly aggressive, metastatic breast cancer and are being used to evaluate combination therapy with alpha-particle emitter labeled HER2/neu reactive antibodies.
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http://dx.doi.org/10.18632/oncotarget.19174DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5620237PMC
September 2017

Pharmacokinetics, microscale distribution, and dosimetry of alpha-emitter-labeled anti-PD-L1 antibodies in an immune competent transgenic breast cancer model.

EJNMMI Res 2017 Dec 18;7(1):57. Epub 2017 Jul 18.

Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, CRBII 4M.61, 1550 Orleans Street, Baltimore, MD, 21231, USA.

Background: Studies combining immune checkpoint inhibitors with external beam radiation have shown a therapeutic advantage over each modality alone. The purpose of these works is to evaluate the potential of targeted delivery of high LET radiation to the tumor microenvironment via an immune checkpoint inhibitor.

Methods: The impact of protein concentration on the distribution of In-DTPA-anti-PD-L1-BC, an In-antibody conjugate targeted to PD-L1, was evaluated in an immunocompetent mouse model of breast cancer. Ac-DOTA-anti-PD-L1-BC was evaluated by both macroscale (ex vivo biodistribution) and microscale (alpha-camera images at a protein concentration determined by the In data.

Results: The evaluation of In-DTPA-anti-PD-L1-BC at 1, 3, and 10 mg/kg highlighted the impact of protein concentration on the distribution of the labeled antibody, particularly in the blood, spleen, thymus, and tumor. Alpha-camera images for the microscale distribution of Ac-DOTA-anti-PD-L1-BC showed a uniform distribution in the liver while highly non-uniform distributions were obtained in the thymus, spleen, kidney, and tumor. At an antibody dose of 3 mg/kg, the liver was dose-limiting with an absorbed dose of 738 mGy/kBq; based upon blood activity concentration measurements, the marrow absorbed dose was 29 mGy/kBq.

Conclusions: These studies demonstrate that Ac-DOTA-anti-PD-L1-BC is capable of delivering high LET radiation to PD-L1 tumors. The use of a surrogate SPECT agent, In-DTPA-anti-PD-L1-BC, is beneficial in optimizing the dose delivered to the tumor sites. Furthermore, an accounting of the microscale distribution of the antibody in preclinical studies was essential to the proper interpretation of organ absorbed doses and their likely relation to biologic effect.
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http://dx.doi.org/10.1186/s13550-017-0303-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5515722PMC
December 2017

Study protocol of a pragmatic, randomised controlled pilot trial: clinical effectiveness on smoking cessation of traditional and complementary medicine interventions, including acupuncture and aromatherapy, in combination with nicotine replacement therapy.

BMJ Open 2017 06 2;7(5):e014574. Epub 2017 Jun 2.

Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.

Introduction: Nicotine dependence is a disease, and tobacco use is related to 6 million deaths annually worldwide. Recently, in many countries, there has been growing interest in the use of traditional and complementary medicine (T&CM) methods, especially acupuncture, as therapeutic interventions for smoking cessation. The aim of this pilot study is to investigate the effectiveness of T&CM interventions on smoking cessation.

Methods And Analysis: The STOP (Stop Tobacco Programme using traditional Korean medicine) study is designed to be a pragmatic, open-label, randomised pilot trial. This trial will evaluate whether adding T&CM methods (ie, ear and body acupuncture, aromatherapy) to conventional cessation methods (ie, nicotine replacement therapy (NRT), counselling) increases smoking cessation rates. Forty participants over 19 years old who are capable of communicating in Korean will be recruited. They will be current smokers who meet one of the following criteria: (1) smoke more than 10 cigarettes a day, (2) smoke less than 10 cigarettes a day and previously failed to cease smoking, or (3) smoke fewer than 10 cigarettes a day and have a nicotine dependence score (Fagerstrom Test for Nicotine Dependence) of 4 points or more. The trial will consist of 4 weeks of treatment and a 20 week follow-up period. A statistician will perform the statistical analyses for both the intention-to-treat (all randomly assigned participants) and per-protocol (participants who completed the trial without any protocol deviations) data using SAS 9.1.3.

Ethics And Dissemination: This study has been approved by the Institutional Review Board (IRB) of the Dunsan Korean Medicine Hospital of Daejeon University (IRB reference no: DJDSKH-15-BM-11-1, Protocol No. version 4.1.).The protocol will be reapproved by IRB if it requires amendment. The trial will be conducted according to the Declaration of Helsinki, 7th version (2013). This study is designed to minimise the risk to participants, and the investigators will explain the study to the participants in detail. As an ethical clinical trial, the control group will also be given conventional cessation treatments, including NRT and counselling. Participants will be screened and provided with a registration number to protect their personal information. Informed consent will be obtained from the participants prior to enrolling them in the trial. Participants will be allowed to withdraw at anytime without penalty.

Trial Registration Number: ClinicalTrials.gov (NCT02768025); pre-results.
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http://dx.doi.org/10.1136/bmjopen-2016-014574DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623405PMC
June 2017

Imaging of Programmed Cell Death Ligand 1: Impact of Protein Concentration on Distribution of Anti-PD-L1 SPECT Agents in an Immunocompetent Murine Model of Melanoma.

J Nucl Med 2017 10 18;58(10):1560-1566. Epub 2017 May 18.

Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland

Programmed cell death ligand 1 (PD-L1) is part of an immune checkpoint system that is essential for preventing autoimmunity and cancer. Recent approaches in immunotherapy that target immune checkpoints have shown great promise in a variety of cancers, including metastatic melanoma. The use of targeted molecular imaging would help identify patients who will best respond to anti-PD-L1 treatment while potentially providing key information to limit immune-related adverse effects. Recently, we developed an antibody-based PD-L1-targeted SPECT agent-In-diethylenetriaminepentaacetic acid (DTPA)-anti-PD-L1-to identify PD-L1-positive tumors in vivo. To best use such PD-L1-targeted imaging agents, it is important, as a first step, to understand how the signal is affected by different parameters. We evaluated the impact of protein concentration on the distribution of In-DTPA-anti-PD-L1 in a murine model of aggressive melanoma. In-DTPA-anti-PD-L1 (dissociation constant, 0.6 ± 0.1 nM) demonstrated increased uptake in B16F10 tumors at protein concentrations equaling or exceeding 1 mg/kg at 24 h and 3 mg/kg at 72 h. At 24 h, the PD-L1-rich spleen and lungs demonstrated decreasing uptake with increasing protein concentration. At 72 h, uptake in the thymus was significantly increased at protein concentrations of 3 mg/kg or greater. Both time points demonstrated increased tracer amounts remaining in circulation as the amount of cold antibody was increased. These studies demonstrate that In-DTPA-anti-PD-L1 is capable of identifying tumors that overexpresses PD-L1 and monitoring the impact of PD-L1-rich organs on the distribution of anti-PD-L1 antibodies.
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http://dx.doi.org/10.2967/jnumed.117.193268DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632734PMC
October 2017

Inhibitors of STAT3, β-catenin, and IGF-1R sensitize mouse PIK3CA-mutant breast cancer to PI3K inhibitors.

Mol Oncol 2017 05 6;11(5):552-566. Epub 2017 Apr 6.

Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Although mutations in the phosphoinositide 3-kinase catalytic subunit (PIK3CA) are common in breast cancer, PI3K inhibitors alone have shown modest efficacy. We sought to identify additional pathways altered in PIK3CA-mutant tumors that might be targeted in combination with PI3K inhibitors. We generated two transgenic mouse models expressing the human PIK3CA-H1047R- and the -E545K hotspot-mutant genes in the mammary gland and evaluated their effects on development and tumor formation. Molecular analysis identified pathways altered in these mutant tumors, which were also targeted in multiple cell lines derived from the PIK3CA tumors. Finally, public databases were analyzed to determine whether novel pathways identified in the mouse tumors were altered in human tumors harboring mutant PIK3CA. Mutant mice showed increased branching and delayed involution of the mammary gland compared to parental FVB/N mice. Mammary tumors arose in 30% of the MMTV-PIK3CA-H1047R and in 13% of -E545K mice. Compared to MMTV-Her-2 transgenic mouse mammary tumors, H1047R tumors showed increased upregulation of Wnt/β-catenin/Axin2, hepatocyte growth factor (Hgf)/Stat3, insulin-like growth factor 2 (Igf-2), and Igf-1R pathways. Inhibitors of STAT3, β-catenin, and IGF-1R sensitized H1047R-derived mouse tumor cells and PIK3CA-H1047R overexpressing human HS578T breast cancer cells to the cytotoxic effects of PI3K inhibitors. Analysis of The Cancer Genome Atlas database showed that, unlike primary PIK3CA-wild-type and HER-2 breast carcinomas, PIK3CA-mutant tumors display increased expression of AXIN2, HGF, STAT3, IGF-1, and IGF-2 mRNA and activation of AKT, IGF1-MTOR, and WNT canonical signaling pathways. Drugs targeting additional pathways that are altered in PIK3CA-mutant tumors may improve treatment regimens using PI3K inhibitors alone.
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http://dx.doi.org/10.1002/1878-0261.12053DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5527464PMC
May 2017

Disambiguation and Integration in Korean Relative Clause Processing.

J Psycholinguist Res 2017 Aug;46(4):827-845

Department of Languages and Cultures, Nagoya University, Nagoya, Japan.

Previous studies on Korean relative clauses (RC) show that, with respect to processing, object-extracted relative clauses (ORC) are more difficult to process at the head noun than subject-extracted relative clauses within temporarily ambiguous contexts. ORCs, however, are predicted by experience-based processing models to incur a greater processing cost during early processing stages at the RC verb, since it is a likely locus of disambiguation for RCs in Korean, and because ORCs are a less frequent structure. Consequently, the current study investigates whether processing difficulty for ORCs manifests itself at the RC verb using eye-tracking methods, a simple sentence structure and a sentential-decision task. The results revealed significantly increased go-past reading times for ORCs at the RC verb. We believe this is a result of a less frequent structure being more difficult to parse during disambiguation. Accordingly, experience-based models of processing can accurately predict difficulty for ORCs in Korean.
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http://dx.doi.org/10.1007/s10936-016-9461-zDOI Listing
August 2017

Smoking cessation programmes using traditional medicine in Korea.

BMC Complement Altern Med 2016 Dec 1;16(1):494. Epub 2016 Dec 1.

Department of Preventive Medicine, College of Korean Medicine, Daejeon University, 62 Daehak-ro, Daejeon, 34520, Republic of Korea.

Background: There are growing interests in using various methods including traditional and complementary medicines (T&CM) for tobacco control. The study aimed to introduce how traditional Korean medicine (TKM) applied to smoking cessation programmes in Korea and to show the detail information of each programme for designing other smoke cessation programmes.

Methods: Reports of the smoke cessation programmes in Korea were searched on March 10th, 2016, from the webpages of the related agencies and the databases: the Ministry of Health and Welfare, the Korea Health Foundation, the Association of Korean Medicine, PubMed, Google scholar, the RISS, the KISS, the NDSL, and the OASIS. Smoking cessation programmes, projects, or services using traditional Korean medicine (TKM) were included with no language, implementation site, and year restrictions.

Results: The three smoking cessation programmes using TKM in South Korea were the public health centre smoking cessation programme (PHC-SCP), the Ministry of Gender Equality & Family smoking cessation programme (MOGEF-SCP), and the National Health Insurance Service smoking cessation treatment project (NHIS-SCP). All programmes included ear acupuncture and counselling. Manual acupuncture was only used in the NHIS-SCP. The MOGEF-SCP and the NHIS-SCP used herbal medicines selectively. The PHC-SCP and MOGEF-SCP provided education programme and other tools such as non-smoking doll, self-writing handbook. They were run at no cost for participants. Treatment period were different for each programmes, 3 weeks, 4 weeks, 8 to 12 weeks, respectively. Treatment frequency was twice a week for PHC-SCP and MOGEF-SCP, and dependent on each clinic for NHIS-SCP.

Conclusions: This study showed the summaries of the smoking cessation programme that used TKM. The three programmes and the detail information will be a reference for other countries that are going to apply T&CM to their smoking cessation programme. Though TKM integrated smoking cessation programmes had been contributed to stop smoking, persistent efforts are needed to develop more effective and various treatments. In addition, this study suggests that consistent support and systematic reporting system are needed to be successful in non-smoking strategy.
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http://dx.doi.org/10.1186/s12906-016-1462-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5134287PMC
December 2016

Relationship Between Water Intake and Metabolic/Heart Diseases: Based on Korean National Health and Nutrition Examination Survey.

Osong Public Health Res Perspect 2016 Oct 31;7(5):289-295. Epub 2016 Aug 31.

Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Korea.

Objectives: The aim of this study was to identify the correlation between adequate water intake and the prevalence of metabolic/heart diseases.

Methods: We analyzed the data from the 2012 Korea National Health and Nutrition Examination Survey. All participants were divided into Group Above Adequate Intake ( = 736) and Group Below Adequate Intake ( = 4,819) according to water intake. The thresholds were 1.8 L for men and 1.4 L for women based on the World Health Organization report findings. Logistic regression analyses were performed to verify the correlation between water intake and prevalence of hypertension, diabetes mellitus, dyslipidemia, myocardial infarction, and angina pectoris.

Results: There were significant differences between the two groups in terms of the following variables: age, smoking, alcohol, stress, dietary supplements, body weight, physical activity, total calorie intake, water intakes from food, and sodium intake. Participants in Group Above Adequate Intake showed a higher prevalence of hypertension [odds ratio (OR) = 1.22; 95% confidence interval (CI), 0.58-2.55], diabetes mellitus (OR = 1.38; 95% CI, 0.51-3.73), angina pectoris (OR = 0.94; 95% CI, 0.47-1.86), and myocardial infarction (OR = 5.36; 95% CI, 0.67-43.20) than those in Group Below Adequate Intake, whereas the latter showed a slightly higher prevalence of dyslipidemia (OR = 2.25; 95% CI, 0.88-57.84) than the former.

Conclusion: There was no statistically significant association between water intake and any of the metabolic/heart diseases. However, further studies on water intake are needed to confirm our findings.
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http://dx.doi.org/10.1016/j.phrp.2016.08.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5079212PMC
October 2016