• 제목/요약/키워드: Evidence Base Medicine

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What Else Is Needed in the Korean Government's Master Plan for People With Developmental Disabilities?

  • Lee, Jin Yong;Yun, Jieun
    • Journal of Preventive Medicine and Public Health
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    • 제52권3호
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    • pp.200-204
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    • 2019
  • On September 12, 2018, President Jae-In Moon announced the Comprehensive Plan for Lifelong Care for People with Developmental Disabilities, with representatives from the associated government branches (Ministry of Health and Welfare, Ministry of Education, and Ministry of Employment and Labor) in attendance. The goals of this plan are to provide health, medical, rehabilitative, special education, and social welfare services according to the life-stages of the affected individuals; to reduce parental pressure; to promote social interventions; and to enhance community-level participation in order to create a 'welfare society in harmony.' However, in order for the plan to succeed, additional efforts must be made in the following areas. First, an epidemiological survey is needed to understand the scale, prevalence, and incidence of developmental disabilities and to establish an evidence base to support policy development. Second, accurate definitions of developmental disabilities must be established in order to avoid policy discrimination based on impairment type and age. Third, personal evaluations to assess disabled individuals' unmet needs and customized service designs to deliver those needs are required. Fourth, the plan must fulfill the goals of accessibility and fairness that the government intends to provide. Fifth, the government should consider an integrated financial support system and to propose a detailed plan for monetary distributions. Finally, an integrated system that links health, medical, employment, educational, and welfare services must be constructed.

한국 한방화장품 발달 배경 및 연구 현황 (The Background and Current Research Applied to Development of Korean Cosmetics Based on Traditional Asian Medicine)

  • 조가영;박효민;최소웅;권이경;조성아;서병휘;김남일
    • 한국의사학회지
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    • 제30권2호
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    • pp.63-71
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    • 2017
  • Traditional Asian medicine has an extensive evidence base built upon thousands of years of experience within Asia, of curing various diseases. Only recently, within the past two centuries, have modern medical scientists developed interest in traditional Asian medicine. Asian Medicine seems to be regarded only as an adjunctive medicine and viewed as alargely un-proven alternative medicine to complement western medicine, used in some cases to establish a new paradigm of "integrative medicine". This article reviews how Korean herbal cosmetics emerged by applying traditional Asian medicine to the science of cosmetics. The characteristics of Korean herbal cosmetics are examined through examples of history, concepts and traditions. With the advancements in biotechnology, studies are now being conducted on the dermatological effects and processing methods of herbal ingredients, including ginseng. The authors explain the current research on the identification on the active ingredients of herbs, extraction methods, and bio-processing of ingredients to improve the biological efficacies of herbs on the skin. A summary of studies focused on modern reinterpretations of ageing theories, such as 'Seven year aging cycle', are provided. In conclusion, the development of Korean cosmetics products are based on the accumulated knowledge of thousands of years of experience including; 1) practical heritage of traditional Asian medicines such as Donguibogam; 2) excellent medicinal plants, such as ginseng, which are native to Korea; and 3) innovative attempts to modernize materials, processes, and principles.

소아 치과환자에 대한 진정법의 체계적 분석 방법 고찰 (A Review of the Systemic Analysis Method on Dental Sedation for Children)

  • 안소연;이제우;김승오;김종빈
    • 대한소아치과학회지
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    • 제42권4호
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    • pp.331-339
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    • 2015
  • 소아치과에서 협조가 되지 않는 어린이의 치과치료 시 사용하는 진정법은 환자안전을 최우선으로 고려하여야 하며, 의료사고예방을 위한 evidence-based 진료가 필요하다. 근거중심의학의 부상에 따라 치의학계에도 근거중심치의학(Evidence-Based Dentistry)에 대한 관심이 점차 증가하고 있으나 한국의 진정법에 대한 근거중심의 체계적인 연구는 거의 이루어지지 않고 있다. 이 연구의 목적은 체계적인 문헌고찰법을 이용하여 지금까지 국내에 보고된 소아치과진정(요)법을 검토하고, 향후 국내의 근거중심 소아치과 진정법의 발전 방향을 모색하는 것이다. 본 연구는 "한국보건의료연구원의 체계적인 문헌고찰 지침"을 참고하여 국내 5개 데이터베이스 1) Core 검색 데이터베이스- KM base, KISS 2) 학술정보 및 포털 -국회도서관, DBpia, RISS를 검색하였다. "치과진정법" 및 "치과진정요법"으로 검색어를 제안한 총 470편의 논문 중 문헌선택과정의 흐름도를 따라 중복제거 하고 남은 31개의 논문 중 원문이 제공되는 문헌을 모두 취합한 총 20개 문헌을 분석대상으로 삼았다. 이번 체계적 문헌고찰은 한국 소아치과 영역에서 지난 25년간 시행된 치과진정법에 관한 일관된 근거(evidence)를 확인하기 위하여 GRADE 과정에 정의된 객관적인 기준에 기초하여 진행된 결과, 전체적인 근거는 보통(moderate)의 질로 평가되었다. 그러나, 특히 약물의 추가 투여 부분에 대해서는 매우 낮은(very low)의 질로 평가되었다. 그러므로 향후 안전한 약물의 사용 부분에 대해 보다 체계적으로 잘 고안된 임상 실험이 필요하다.

문헌 내 병명 정보를 활용한 진단 지원 방안 연구 (A Study on Diagnosis Support using Knowledge of Diseases from Literature)

  • 오용택;김안나;김상균;장현철
    • 혜화의학회지
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    • 제23권1호
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    • pp.13-20
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    • 2014
  • Objectives : Clinical data in traditional medicine, such as Korean medicine, traditional Chinese medicine have a long history of accumulating evidence and these rich data are recorded in classic literature. We have conducted a study of developing an algorithm that support clinical diagnosis with composing both users knowledge and data obtained from literature. In order to define necessary information and required steps in diagnosis procedure, we have established a clinical diagnostic procedure including a step of collecting patients symptoms, a step of determining candidates, a step of diagnostic decisions, a step of deciding of treatment and a step of adjusting medicinal treatment. Methods : Our study have been based on the following premises. 1. Using data obtained from literature contributes to accurate diagnosis 2. Displaying the data before users request contributes to accurate conclusion. Displaying before users request enable users to recognize their overlooking a fact on purpose or not. 3. Checking symptoms that are commonly accompanied with a group of diseases that accompany symptoms appealed by a patient contributes to accurate conclusion. These symptoms are worthy of checking. 4. Comparing more than two candidates contributes to accurate conclusion. Users can compare their accompanied symptoms with patients symptoms and this helps users to make a decision. Results : Based on the above premises, we have developed an literature based algorithm to provide various functions, such as recommending symptoms to check, comparing groups of symptoms, differential diagnosis, recommending medicinal materials to prescribe, and more. Conclusions : By the results of simulation with virtual diagnostic scenario, we concluded this algorithm is useful helping clinician in diagnosis procedure.

Recognition of Transmembrane Protein 39A as a Tumor-Specific Marker in Brain Tumor

  • Park, Jisoo;Lee, Hyunji;Tran, Quangdon;Mun, Kisun;Kim, Dohoon;Hong, Youngeun;Kwon, So Hee;Brazil, Derek;Park, Jongsun;Kim, Seon-Hwan
    • Toxicological Research
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    • 제33권1호
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    • pp.63-69
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    • 2017
  • Transmembrane protein 39A (TMEM39A) belongs to the TMEM39 family. TMEM39A gene is a susceptibility locus for multiple sclerosis. In addition, TMEM39A seems to be implicated in systemic lupus erythematosus. However, any possible involvement of TMEM39A in cancer remains largely unknown. In the present report, we provide evidence that TMEM39A may play a role in brain tumors. Western blotting using an anti-TMEM39A antibody indicated that TMEM39A was overexpressed in glioblastoma cell lines, including U87-MG and U251-MG. Deep-sequencing transcriptomic profiling of U87-MG and U251-MG cells revealed that TMEM39A transcripts were upregulated in such cells compared with those of the cerebral cortex. Confocal microscopic analysis of U251-MG cells stained with anti-TMEM39A antibody showed that TMEM39A was located in dot-like structures lying close to the nucleus. TMEM39A probably located to mitochondria or to endosomes. Immunohistochemical analysis of glioma tissue specimens indicated that TMEM39A was markedly upregulated in such samples. Bioinformatic analysis of the Rembrandt knowledge base also supported upregulation of TMEM39A mRNA levels in glioma patients. Together, the results afford strong evidence that TMEM39A is upregulated in glioma cell lines and glioma tissue specimens. Therefore, TMEM39A may serve as a novel diagnostic marker of, and a therapeutic target for, gliomas and other cancers.

위 절개술 접근과 긴 겸자를 이용한 식도 내 이물 제거 5례 (Gastrotomy Approach Retrieval of Esophageal Foreign Body using Long Forceps Technique in Five Dogs)

  • 윤헌영;강명곤;정순욱
    • 한국임상수의학회지
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    • 제26권6호
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    • pp.628-631
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    • 2009
  • 이물 섭취 병력을 보이는 다섯 마리 개가 건국대학교 부속 동물병원과 한강 동물병원에 내원하였다. 신체 검사에서 무기력, 식욕 감퇴, 구토 증상을 보였으며 일반 방사선 사진에서 심장 앞쪽 또는 뒤쪽 흉부 식도에 이물이 걸려 있는 것을 확인하였다. 식도의 조영 촬영에서 큰 이물에 의한 식도 팽창을 확인 할 수 있었으며 흉강 내로의 조영제 누수는 관찰 되지 않았다. 위 절개술을 통한 식도 내 이물 제거를 긴 겸자를 이용하여 실시 하였다. 다섯 마리 모두에서 식도 내 이물을 성공적으로 제거하였다. 수술 후 10일 또는 2년에 정기 검진이 마무리 되었으며 수술과 관련한 구토, 연하 곤란, 식욕 저하, 과다 유연과 같은 합병 증상이 없음을 확인하였다.

Comparative Analysis of COVID-19 Infection Prevention Control Guidelines from Seven Countries: Implications on COVID-19 Response and Future Guidelines Development

  • Jeong, Yoolwon;Lee, Sun-Hee
    • 보건행정학회지
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    • 제32권3호
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    • pp.304-316
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    • 2022
  • Background: As prevention of coronavirus disease 2019 (COVID-19) transmission in healthcare settings has become a critical component in its effective management, COVID-19 specific infection prevention and control (IPC) guidelines were developed and implemented by numerous countries. Although largely based on the current evidence-base, guidelines show much heterogeneity, as they are influenced by respective health system capacities, epidemiological risk, and socioeconomic status. This study aims to analyze the variations and concurrences of these guidelines to draw policy implications for COVID-19 response and future guidelines development. Methods: The contents of the COVID-19 IPC guidelines were analyzed using the categories and codes developed based on "World Health Organization guidelines on core components." Data analysis involved reviewing, appraising and synthesizing data from guidelines, which were then arranged into categories and codes. Selection of countries was based on the country income level, availability of COVID-19 specific IPC guideline developed at a national or district level. Results: The guidelines particularly agreed on IPC measures regarding application of standard precautions and providing information to patients and visitors, monitoring and audit of IPC activities and staff illnesses, and management of built environment/equipments. The guidelines showed considerable differences in certain components, such as workplace safety measures and criteria for discontinuation of precautions. Several guidelines also contained unique features which enabled a more systematic response to COVID-19. Conclusion: The guidelines generally complied with the current evidence-based COVID-19 management but also revealed variances stemming from differences in local health system capacity. Several unique features should be considered for benchmark in future guidelines development.

단미 한약 복용중 발견한 Gilbert's syndrome 2예 임상고찰 (Report on Two Cases of Gilbert's Syndrome Found in the Process of Administering Herbs)

  • 이종덕;김동웅
    • 동의생리병리학회지
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    • 제28권6호
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    • pp.657-661
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    • 2014
  • Gilbert's syndrome is one that shows a benign course with intermittent unconjugate hyperbilirubinemia without any evidence of hepatobiliary tract disease or hemolysis. It is often found in a health examination or blood laboratory test by chance. In particular, patients who are taking drugs, including herbal medicine should be careful for their medication due to the possibility of associations with changes in liver function because of drug metabolism, sometimes they have to quit the use of the medication for a certain period and often they should get an additional test. Two male patients increased serum total bilirubin level without other systemic symptoms in screening test for clinical herb medicine pharmacokinetics study. Therefor they was diagnosed with suspected Gilbert's syndrome. They had been calory deprivation test with 24 hours fasting state. They also performed liver function test and ultrasonogram for evaluation of hepatobiliary tract disease. Total serum bilirubin was markedly increased, especially unconjugate bilirubin level higher over the two times than base line after they had been calory deprivation for 24 hours, They was not found another abnormality all laboratory results and physical examination. This study is a report on two cases of hyperbilirubinemia, diagnosed as Gilbert's syndrome, which were found in the process of a clinical pharmacokinetic study of a decoction of medicinal herbs.

진무탕으로 임상적 관해가 유도된 크론병 환자: 증례보고 (Clinical Remission of Crohn's Disease Induced by Herbal Decoction (Jinmoo-tang): A Case Report)

  • 이병희;원지윤;이향숙
    • 동의생리병리학회지
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    • 제35권6호
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    • pp.255-260
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    • 2021
  • Crohn's disease (CD) is an idiopathic inflammatory bowel disease (IBD) with unknown etiopathogenesis. Currently there are no definitive treatment modalities for CD. This case report presents clinical remission and its maintenance of CD induced by Korean herbal medicine treatment. A 56-year-old male patient diagnosed as CD by capsule endoscopy presented to a Korean Medicine clinic with severe abdominal pain as a chief complaint. Despite taking 5-aminosalicylic acid and immunosuppressant for 2 years, his abdominal pain was worsening at the time of visit. Treatment was initiated with Jinmoo-tang based on pattern identification and continued for approximately a year with some modifications according to patient's symptom changes. He was mainly given Jinmoo-Tang for a year and clinical remission was achieved; he could stop taking western medications. For 6 years since then, he took Korean medicine from time to time when he felt his condition went down and he is still maintaining remission. There were no adverse events reported. This case report suggests that individualized Korean herbal medicine treatment may have the potential for induction and maintenance of clinical remission of CD. Further research is warranted to establish an evidence-base for such approach.

CT99 발현 신경 세포주에서 익기안신탕(益氣安神湯)의 신경보호 및 항치매 효과 (Effect of the neuroprotetion and anti-Alzheimer's disease in CT99-induced Neuro 2A cells by Ikgiansintang water extract)

  • 황연규;이소연;윤현덕;신오철;박창국;박치상
    • 대한한의학방제학회지
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    • 제13권1호
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    • pp.103-121
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    • 2005
  • Alzheimer's disease(AD) is a geriatric dementia that is widespread in old age. In the near future AD will be the biggest problem in public health service. It has been widely believed that $A{\beta}$ peptide devided from APP causes apoptotic neurotoxicity in AD brain. However, recent evidence suggests that n99 may be an important factor causing neurotoxicity in AD. Mouse Neuro 2A cells expressed with CT99 exhibited remarkable apoptotic cell damage. We invesgated the protective effects of Ikgiansintang water extract(IGA). Findings from our experiment have shown that IGA inhibits the activities of CT99, which has neurotoxicities and apoptotic activities in cell line. In addition treatment of IGA($50{\mu}g/ml$ for 24 hours) partially prevented CT99-induced cytotoxicity in Neuro 2A cells. As the result of this study, In IGA group, the apoptosis in the nervous system is inhibited, the repair against the degerneration of Neuro 2A cells by n99 expression is promoted. Base on these findings, IGA may be beneficial for the treatment of AD.

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