• Korean Journal of Radiology
• /
• v.22 no.2
• /
• pp.263-280
• /
• 2021

Percutaneous transthoracic needle biopsy (PTNB) is one of the essential diagnostic procedures for pulmonary lesions. Its role is increasing in the era of CT screening for lung cancer and precision medicine. The Korean Society of Thoracic Radiology developed the first evidence-based clinical guideline for PTNB in Korea by adapting pre-existing guidelines. The guideline provides 39 recommendations for the following four main domains of 12 key questions: the indications for PTNB, pre-procedural evaluation, procedural technique of PTNB and its accuracy, and management of post-biopsy complications. We hope that these recommendations can improve the diagnostic accuracy and safety of PTNB in clinical practice and promote standardization of the procedure nationwide.

• Clinical Endoscopy
• /
• v.55 no.2
• /
• pp.167-182
• /
• 2022

Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Cardiopulmonary complications are usually temporary. Most patients recover without sequelae. However, they may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.1
• /
• pp.239-247
• /
• 2016

Background: The overall cervical cancer incidence rate is low in Iran; however, because of a higher risk of death for cervical cancer, a disease that kills women in middle age, a cervical cancer control program is needed. The aim of this study was to provide consensus recommendation for cervical cancer prevention in Iran and other Muslim societies with low incidences of cervical cancer. Materials and Methods: Through a practical guideline development cycle, we developed six questions that were relevant to produce the recommendation. We reviewed 190 full text records of cervical cancer in Iran (1971 to 2013) of which 13 articles were related to the data needed to answer the recommendation questions. We also reviewed World Health Organization, IARC, GLOBOCAN report, Iran Ministry of Health cancer registry report and 8 available foreign countries guidelines. Lastly, we also evaluated the Pap smear results of 825 women who participated in the Iranian HPV survey, of whom 328 were followed-up after a 5-year interval. Results: The obtained data highlighted the burden of HPV and cervical cancer situation in Iran. Experts emphasized the necessity of a cervical cancer screening program for Iranian women, and recommended an organized screening program with a cytological evaluation (Pap smear) that would start at the age of 30 years, repeated every 5 years, and end at the age of 69 years. Meanwhile, there is no need for screening among women with a hysterectomy, and screening should be postponed to post-partum among pregnant women. Conclusions: An organized cervical cancer screening is a necessity for Iran as more than 500-900 women in middle age diagnosed with an invasive cervical cancer every year cannot be ignored. This recommendation should be taken into account by the National Health System of Iran and Muslim countries with shared culture and behavior patterns. CUBA HPV test could be consideration in countries Muslim country with appropriate budget, resources and facility.

• The Journal of Pediatrics of Korean Medicine
• /
• v.32 no.4
• /
• pp.121-140
• /
• 2018

Objectives This research was aimed to analyze and assess the articles of qualitative research of Pediatrics by following Consolidated Criteria for Reporting Qualitative Research (COREQ). Methods Two researchers analyzed and assessed the reports' quality and appropriateness based on COREQ guideline. The articles that failed to achieve consensus from the two researchers, the third researcher made a final decision. Results A total of fifty-six reports which used caregivers as participants, were selected and adopted qualitative research methods were chosen. In most qualitative studies, COREQ was not implemented. Some parts of the studies were poorly described and elaborated when reviewing them based on the COREQ guidelines. In the 'Research team and reflexivity', there was lack of description about the researcher. In the 'Study design', there were no detailed descriptions on the approaches they took in recruiting their study participants. There was not enough detail reflexivity participants who refused, and where the recruitment took place. There were also no records of whether there was a pilot test or a data saturation. In 'Analysis and findings' section, there were few articles mentioning Participant checking, and the main opinion of the participants were well analyzed in all the papers, but excluding opinions of few participants. Conclusions There are still many qualitative studies that have caregivers as participants, in the field of pediatrics. However, methodological skills are insufficient. The use of the COREQ guidelines should be further implemented for more robust and methodological improvement.

• Tuberculosis and Respiratory Diseases
• /
• v.85 no.1
• /
• pp.1-10
• /
• 2022

Pulmonary hypertension (PH) is a condition of increased blood pressure in the pulmonary arteries and is diagnosed with an increased a mean pulmonary artery pressure ≥25 mm Hg. This condition may be associated with multiple clinical situations. Based on pathophysiological mechanisms, clinical presentation, hemodynamic profiles, and treatment strategies, the patients were classified into five clinical groups. Although there have been major advances in the management of PH, it is still associated with significant morbidity and mortality. The diagnosis and treatment of PH have been performed mainly by following European guidelines, even in Korea because the country lacks localized PH guidelines. European treatment guidelines do not reflect the actual status of Korea. Therefore, the European diagnosis and treatment of PH have not been tailored well to suit the needs of Korean patients with PH. To address this issue, we developed this guideline to facilitate the diagnosis and treatment of PH appropriately in Korea, a country where the consensus for the diagnosis and treatment of PH remains insufficient. This is the first edition of the guidelines for the diagnosis and treatment of PH in Korea, and it is primarily based on the '2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension.' with the acceptance and adaptation of recent publications of PH.

• Korean Journal of Clinical Pharmacy
• /
• v.33 no.3
• /
• pp.153-167
• /
• 2023

Objective: Bipolar disorder displays a spectrum of manifestations, including manic, hypomanic, depressive, mixed, psychotic, and atypical episodes, contributing to its chronic nature and association with heightened suicide risk. Creating effective pharmacotherapy guidelines is crucial for managing bipolar disorder and reducing its prevalence. Treatment algorithms grounded in science have improved symptom management, but variations in recommended medications arise from research differences, healthcare policies, and cultural nuances globally. Methods: This study compares Korea's bipolar disorder treatment algorithm with guidelines from the UK, Australia, and an international association. The aim is to uncover disparities in key recommended medications and their underlying factors. Differences in CYP450 genotypes affecting drug metabolism contribute to distinct recommended medications. Variances also stem from diverse guideline development approaches-expert consensus versus metaanalysis results-forming the primary differences between Korea and other countries. Results: Discrepancies remain in international guidelines relying on meta-analyses due to timing and utilized studies. Drug approval speeds further impact medication selection. However, limited high-quality research results are the main cause of guideline variations, hampering consistent treatment conclusions. Conclusion: Korea's unique Delphi-based treatment algorithm stands out. To improve evidence-based recommendations, large-scale studies assessing bipolar disorder treatments for the Korean population are necessary. This foundation will ensure future recommendations are rooted in scientific evidence.

• International Journal of Stem Cells
• /
• v.17 no.2
• /
• pp.102-112
• /
• 2024

An organoid is a self-organized three-dimensional structure derived from stem cells that mimics the structure, cell composition, and functional characteristics of specific organs and tissues and is used for evaluating the safety and effectiveness of drugs and the toxicity of industrial chemicals. Organoid technology is a new methodology that could replace testing on animals testing and accelerate development of precision and regenerative medicine. However, large variations in production can occur between laboratories with low reproducibility of the production process and no internationally agreed standards for quality evaluation factors at endpoints. To overcome these barriers that hinder the regulatory acceptance and commercialization of organoids, Korea established the Organoid Standards Initiative in September 2023 with various stakeholders, including industry, academia, regulatory agencies, and standard development experts, through public and private partnerships. This developed general guidelines for organoid manufacturing and quality evaluation and for quality evaluation guidelines for organoid-specific manufacturing for the liver, intestines, and heart through extensive evidence analysis and consensus among experts. This report is based on the common standard guideline v1.0, which is a general organoid manufacturing and quality evaluation to promote the practical use of organoids. This guideline does not focus on specific organoids or specific contexts of use but provides guidance to organoid makers and users on materials, procedures, and essential quality assessment methods at end points that are essential for organoid production applicable at the current technology level.

• Clinical Psychopharmacology and Neuroscience
• /
• v.16 no.4
• /
• pp.434-448
• /
• 2018

Objective: The Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was first published in 2002 through an expert consensus of opinion, and updated in 2006, 2010, and 2014. This study constitutes the fourth revision of the KMAP-BP. Methods: A 50-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for various phases of adult bipolar disorder and six items for pediatric bipolar disorder. The review committee included 84 Korean psychiatrists and 43 child and adolescent psychiatry experts. Results: The preferred first-step strategies for acute mania were the combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP), MS monotherapy, and AAP monotherapy. A combination of a MS and an AAP, and AAP monotherapy were preferred for psychotic mania. The first-step strategies for mild to moderate bipolar depression were monotherapy with MS, AAP, or lamotrigine (LMT), and the combination of a MS and an AAP or LMT, or a combination of an AAP and LMT. The combination of two among a MS, AAP, and LMT were preferred for non-psychotic severe depression. A combination of a MS and an AAP or the combination of an AAP with an antidepressant or LMT were the first-line options for psychotic severe depression. Conclusion: The recommendations of the KMAP-BP 2018 have changed from the previous version by reflecting recent developments in pharmacotherapy for bipolar disorder. KMAP-BP 2018 provides clinicians with a wealth of information regarding appropriate strategies for treating patients with bipolar disorder.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.32 no.4
• /
• pp.185-196
• /
• 2018

The purpose of this study is to evaluate the current inter-expert agreement of Sasang Constitution Medicine (SCM), to expand the current knowledge on the causes of imperfect inter-expert agreement, and to explore possible solutions for improving inter-expert agreement. A literature search was conducted to gather data on the studies on diagnosis of SCM. The 127 articles included in this analysis had a mean 4.1 publications per year, 56.0% published in the Journal of Sasang Constitutional Medicine between the year of 1987 and 2017. SCM specialist participated in 96.3% of all the expert judgment cases. Inter-expert agreement was reported in 14.8% of the cases that had two or more experts. We recommend that expert panels integrate the results of current status of diagnostic consensus into guideline development and strengthen expert education and training with the aim of improving SCM diagnostic accuracy.

• Journal of Engineering Education Research
• /
• v.20 no.4
• /
• pp.21-27
• /
• 2017

The purpose of this study is to provide basic data and guideline to STEM(Science, Technology, Engineering, Mathematics) educators who prepare engineering education in elementary and secondary school. For this, this study develops a composition model for engineering education program of elementary and secondary school. To do this, a literature research, experts interview and Delphi survey were conducted. Through the literature research, we extracted the components of model for engineering education program of elementary and secondary school and then made a first draft of the model. The draft was revised by experts while Delphi survey was used to validate the model based on Delphi panels' opinions. The panels for the Delphi survey consisted of 51 experts in the STEM education field. The survey was conducted three different times and importance survey was included in the third stage. The conclusions of this study were as follows: First, the model consist of definition, 4 directions, 4 characteristics, 3 educational goals according to school level, educational contents area and element, teaching and learning method and evaluation method. The educational contents area and element consist of 2 major areas, 7 areas and 18 elements. Second, all components of the developed model were valid in most of the statistics such as mean, standard deviation, the degree of consensus and convergence, and CVR(Content Validity Ratio). Third, importance for education contents area and element according to the school level are analyzed.