The Use of Complementary and Alternative Medicine in a General Population in South Korea: Results from a National Survey in 2006

The purpose of this survey was to obtain information on the prevalence, costs, and patterns of use of complementary and alternative medicine (CAM) in a general population in the Republic of Korea. In 2006, we conducted nationwide and population-weighted personal interviews with 6,021 adults ranging from 30 to 69 yr of age; the final sample consisted of 3,000 people with a 49.8% response rate. In addition to their general socio-demographics, the respondents were asked about their use of CAM during the previous 12-month period, costs, sources of information, and reasons for use. The prevalence of use overall was 74.8%, while biologically based CAM therapies were the most likely type of use (65.4%). The median annual out-of-pocket expenditures for CAM therapies was about US$203. The primary reason for using CAM was for disease prevention and health promotion (78.8%). The main source of advice about CAM therapies use was most likely to be from family and friends (66.9%). Our study suggests that CAM use has been and continues to be very popular in South Korea. Conventional western medical doctors and governments should obtain more evidence and become more interested in CAM therapies

The Efficacy of Preemptive Analgesia With Pregabalin in Septoplasty

ObjectivesPregabalin is used to treat neuropathic pain and has shown analgesic properties in postoperative pain. The aim of this study was to investigate the effectiveness and safety of pregabalin in reducing postoperative pain in patients after septoplasty.MethodsForty-seven patients scheduled for elective septoplasty were randomly assigned to groups that received either pregabalin (150 mg) or placebo, both one hour before surgery and 12 hours after the initial dose. Pain (verbal numerical rating scale, VNRS) and side effect assessments were performed at 6, 12, 12 to 24, and 24 to 48 hours postoperatively.ResultsFrom 1 to 12 hours postoperatively, VNRS scores for pain were lower in the pregabalin group (n=24) than in the placebo group (n=23; P<0.05). The number of patients who needed rescue analgesics was lower in the pregabalin group (P=0.042). The incidence of nausea and vomiting did not differ between groups (P=0.666), and the incidence of sedation was higher in the placebo groups (P=0.022).ConclusionThe perioperative administration of oral pregabalin (150 mg twice) is an effective and safe way to reduce early postoperative pain in patients undergoing septoplasty

A semiparametric method to measure predictive accuracy of covariates for doubly censored survival outcomes

Abstract In doubly-censored data, an originating event time and a terminating event time are interval-censored. In certain analyses of such data, a researcher might be interested in the elapsed time between the originating and terminating events as well as regression modeling with risk factors. Therefore, in this study, we introduce a model evaluation method to measure the predictive ability of a model based on negative predictive values. We use a semiparametric estimate of the predictive accuracy to provide a simple and flexible method for model evaluation of doubly-censored survival outcomes. Additionally, we used simulation studies and tested data from a prostate cancer trial to illustrate the practical advantages of our approach. We believe that this method could be widely used to build prediction models or nomograms

Treating Allies with Respect: The Importance of Status in the Politics of Asymmetric Alliances

Over the past three decades, the North Korean nuclear weapons program has rapidly evolved into a major international conundrum. In this context, the United States and the Republic of Korea (ROK) should have been able to display a high level of alliance cohesion, primarily because of: 1) the presence of a shared security threat; and 2) the asymmetric structure of the alliance. Curiously, however, Seoul and Washington have frequently clashed over the North Korean nuclear problem throughout the post-Cold War period, and this deeply puzzling state of relations lies at the heart of the dissertation. The goals of this project are twofold.The first goal is to explain why the US and the ROK have failed to cooperate effectively over the management of the shared nuclear threat, and this I do so by focusing on the South Korean side of the story. The central argument that I advance is that for the South Koreans, having an opportunity to significantly influence the management of foreign policy issues critical to their national interest has been an important privilege that they believed they were entitled to per their claimed middle power status. This prerogative in turn had to be respected by the United States for their aspired status to be recognized and thereby legitimized. Otherwise, the South Koreans would experience status inconsistency and consequently become more prone to defying cooperation with the Americans. I conduct in-depth case studies of the First Korean Nuclear Crisis of 1993-94 and the Second Korean Nuclear Crisis of 2002-06 to demonstrate the validity of my claims. The second goal of the project is to show that the above line of argument can be generalized to explain instances of low levels of cohesion observable in other cases of asymmetrical alliances as well. For this purpose, I conduct an in-depth case study of the US-France alliance relations during the presidency of Charles de Gaulle (1958-1969), up to France’s withdrawal from NATO in 1966. Overall, in both empirical and theoretical terms, this dissertation contributes to our understanding of the nature of conflicts that can develop within asymmetrical alliances more generally

Elevated serum ferritin level is associated with the incident type 2 diabetes in healthy Korean men: a 4 year longitudinal study.

Elevated ferritin concentration has been implicated in the etiology of type 2 diabetes. Accumulating evidence, mostly from studies conducted on western populations, has demonstrated a strong association between the elevated ferritin concentrations and incident type 2 diabetes. In Asian populations, however, the longitudinal studies investigating the association of elevated serum ferritin levels and type 2 diabetes are lacking. In present study, we aimed to determine whether elevated serum ferritin levels are related to the incident type 2 diabetes in healthy Korean men.This 4 year longitudinal observational study was conducted at the Asan Medical Center, Seoul, Republic of Korea. The study population consisted of 2,029 men without type 2 diabetes who underwent routine health examination in 2007 (baseline) and 2011 (follow-up). Baseline serum ferritin concentrations were measured by chemiluminescent two-site sandwich immunoassay. In multiple-adjusted model, the relative risk (RR) for incident type 2 diabetes was significantly higher in highest compared with the lowest ferritin quartile category, even after adjusting for confounding variables including homeostasis model assessment of insulin resistance (RR = 2.17, 95% confidence interval 1.27-3.72, P for trend = 0.013).These results demonstrated that elevated level of serum ferritin at baseline was associated with incident type 2 diabetes in an Asian population

Graphical analysis of the expression levels of pericyte markers in normal placentas and CHMs.

<p>α -SMA expression in the villous stroma (a) and stromal vessels (b) is consistently lower in CHMs than in normal placentas, regardless of gestational age. (c-d), PDGFR expression in the villous stroma (c) and around stromal vessels (d) increases linearly with gestational age in normal placentas, whereas its expression does not change with gestational age in CHM, although the difference is not statistically significant. (e-f), Desmin expression in the villous stroma of normal placentas increases linearly with gestational age up to 8 weeks, whereas it does not markedly change in CHMs (e). Desmin expression is not detected in stromal vessels of normal placentas or CHMs at any gestational age (f). (*p<0.05; **p<0.01; ***p<0.001).</p

Histological changes and immunohistochemical labeling for pericyte markers in normal placentas showing significantly increased expressions of α-SMA and PDGFR-β along the vascular maturation and lumen formation.

<p>At week 4 of gestation (GW4), chorionic villi do not exhibit signs of vasculogenesis (a). Expression of α-SMA is confined to the chorionic plate (b, arrows), but not expressed in the villous stroma (b, inlet). PDGFR-β (c) and Desmin (d) are not expressed in the villous stroma. During weeks 5–6 of gestation (GW5-6), when the stroma begins to form angiogenic cell cords (e, arrows), expression of α-SMA begins to extend from chorionic plate (CP) to the villous stroma (f, inlet), but expression of α-SMA, PDGFR-β and desmin is not detected in angiogenic cell cords (arrows in f, g, h). After week 7, when the villous stroma forms mature blood vessels with lumens (i), expression of α-SMA (j and n) and PDGFR-β (k and o) markedly increases in the villous stroma forming a reticular network and encircles blood vessels (arrows in j, n, k, and o). Desmin is slightly increased in the villous stroma at week 10 (p), but is not detected in vascular structures during the entire study period (arrows in h, l, and p).</p

Defective Pericyte Recruitment of Villous Stromal Vessels as the Possible Etiologic Cause of Hydropic Change in Complete Hydatidiform Mole

<div><p>The pathogenetic mechanism underlying the hydropic change in complete hydatidiform moles (CHMs) is poorly understood. A growing body of data suggests that pericytes play a role in vascular maturation. Since maturation of villous stromal vessels in CHMs is markedly impaired at early stages, we postulated that a defect in pericytes around stromal vessels in chorionic villi might cause vascular immaturity and subsequent hydropic change. To investigate this, we examined several markers of pericytes, namely, α-smooth muscle actin (α-SMA), platelet-derived growth factor receptor-β (PDGFR-β), and desmin, in 61 normally developing placentas and 41 CHMs with gestational ages of 4–12 weeks. The ultrastructure of villous stromal vessels was also examined. Mature blood vessels from normal placentas show patent vascular lumens and formed hematopoietic components in the villous stroma. α-SMA and PDGFR-β expression in the villous stroma gradually increased and extended from the chorionic plate to peripheral villous branches. The labeled cells formed a reticular network in the villous stroma and, after week 7, encircled villous stromal vessels. In comparison, α-SMA and PDGFR-β expression in the villous stroma and stromal vessels of CHMs was significantly lower (p<0.05). Ultrastructurally, endothelial cells in villous stromal vessels in normal placentas were consistently attached by pericytes after week 7 when the vessels formed distinct lumen, whereas the villous stromal vessels in CHMs consisted of linear chains of endothelial cells, often disclosing primitive clefts without hematopoietic cells inside, and neither pericytes nor basal lamina surrounded the endothelial cells at any gestational age studied. This suggests that pericytes recruitment around villous stromal vessels is defective in CHMs and links to the persistent vascular immaturity of the villous stroma in CHMs, which in turns leads to hydropic villi.</p></div