• Clinical and Experimental Reproductive Medicine
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• 제48권3호
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• pp.194-197
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• 2021

Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4-6 based on a lower percentile of 85%-90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m² for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.

• 대한치과의사협회지
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• 제51권1호
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• pp.39-45
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• 2013

Radiographic examinations are used to discover and define the type and extent of disease in many clinical situations. Currently, it is common for dental patients to receive dental radiographic examinations on a routine schedule with little variation in spite of different patient signs and symptoms. Such routine scheduling of radiographic examinations may result in unnecessary patient exposure. There is also the possibility of under-utilization of radiography; this can result in inadequate or excessively delayed diagnosis. Patient selection criteria are descriptions of clinical conditions derived from patient signs, symptoms and history that identify patients who are likely to benefit from a particular radiographic examination. It makes possible making individual decisions based on history, clinical examination and risk factors. The radiographic selection criteria of dentistry have been revised in accordance with recent guidelines and peer-reviewed research in USA and Europe, but the studies of these subjects are not sufficient in our nation. In this review article, the relating factors and update necessity of radiographic selection criteria are discussed.

• 한국임상약학회지
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• 제27권4호
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• pp.276-283
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• 2017

Objective: Dyslipidemia is recognized as a prominent risk factor for cardiovascular and cerebrovascular diseases but it is manageable through therapeutic and lifestyle intervention. Interpreting the latest guidelines is essential for an application of recommendation from guidelines into clinical practice. Therefore, this study aimed to compare the most recent guidelines on dyslipidemia treatment recommendations in Korea and USA. Methods: This study analyzed and compared 2015 Korean guidelines for the management of dyslipidemia, 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline and 2016 supportive guidelines from ACC. Results: A comparison was made focused on the following: target patients based on cardiovascular risk assessment, target goal, and treatment strategies including statin and non-statin therapies. Four target patient groups by risk were suggested in 2015 Korean guideline and cardiovascular risk factors were also considered for initiation of lipid lowering therapy. Titrated statin regimen was recommended by Korean guideline to reach LDL cholesterol and non-HDL cholesterol target level. In 2013 ACC/AHA guideline, four statin benefit group was introduced considering ASCVD risk and high intensity statin or intermediate intensity statin use were recommended without dose titration. 2016 update was to support non-statin therapy based on updated evidence and new consideration of ezetimibe, PCSK9-inhibitor and bile acid sequestrant was brought up. Conclusion: Guidelines are continuously updating as new and important clinical data are constantly released along with the advent of newly approved drugs for lipid disorder. This article provides resources that facilitates uptake of these recommendations into clinical practice.

• 임상간호연구
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• 제29권1호
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• pp.24-41
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• 2023

Purpose: This study aimed to update the previously published nursing practice guideline for prevention of venous thromboembolism (VTE). Methods: The guideline was updated according to the manuals developed by National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), and a Handbook for Clinical Practice Guideline Developer Version 10. Results: The updated nursing practice guideline for prevention of VTE was consisted of 16 domains, 46 subdomains, and 216 recommendations. The recommendations in each domain were: 4 general issues, 8 assessment of risk and bleeding factors, 5 interventions for prevention of VTE, 18 mechanical interventions, 36 pharmacological interventions, 36 VTE prevention starategies for medical patients, 25 for cancer patients, 13 for pregnancy, 8 for surgical patients, 7 for thoractic and cardiac surgery, 16 for orthopedic surgery, 10 for cranial and spinal surgery, 5 for vascular surgery, 13 for other surgery, 3 educations and information, and 2 documentation and report. For these recommendations, the level of evidence was 32.1% for level I, 51.8% for level II, and 16.1% for level III according to the infectious diseases society of America (IDSA) rating system. A total of 112 new recommendations were developed and 49 previous recommendations were deleted. Conclusion: The updated nursing practice guideline for prevention of VTE is expected to serve as an evidence-based practice guideline for prevention of VTE in South Korea. It is recommended that this guideline will disseminate to clinical nursing settings nationwide to improve the effectiveness of prevention of VTE practice.

• 한방안이비인후피부과학회지
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• 제29권4호
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• pp.95-113
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• 2016

Objectives : The purpose of this review is to introduce the recent advance in allergic rhinitis and to provide help in establishing strategy and selection of drugs for Korean medical treatment of allergic rhinitis. Methods : We searched articles about allergic rhinitis comprehensively in PubMed, CNKI, JStage, KISTI. And in order to reflect clinical situation, we also reviewed some profession's writing for practitioners. Results : This review discussed allergic rhinitis's epidemiology, pathophysiology, diagnosis, treatment, prognosis. We found many standardized clinical practice guideline have been published in this field. And some guideline reflected accumulation of medical evidence on interventions in Korean medicine. It suggested that acupuncture, herbal medicine, herbal patch are useful to prevention and alleviate allergic symptoms. But some interventions have heterogeneity due to each nation's medical background. Conclusions : Acupuncture therapy is now recommended world widely for treating allergic rhinitis. But other interventions of Korean medicine are not well recognized in the same manner. We need more research to identify mechanism and rigorous clinical trials to clarify efficacy and safety of Korean medicine intervention.

• Tuberculosis and Respiratory Diseases
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• 제80권4호
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• pp.336-343
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• 2017

Despite progress made in tuberculosis control worldwide, the disease burden and treatment outcome of multidrug-resistant tuberculosis (MDR-TB) patients have remained virtually unchanged. In 2016, the World Health Organization released new guidelines for the management of MDR-TB. The guidelines are intended to improve detection rate and treatment outcome for MDR-TB through novel, rapid molecular testing and shorter treatment regimens. Key changes include the introduction of a new, shorter MDR-TB treatment regimen, a new classification of medicines and updated recommendations for the conventional MDR-TB regimen. This paper will review these key changes and discuss the potential issues with regard to the implementation of these guidelines in South Korea.

• Annals of Clinical Neurophysiology
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• 제23권1호
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• pp.35-45
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• 2021

The utility and accuracy of intraoperative neurophysiological monitoring (IONM) has evolved greatly following the recent development of new devices for neurophysiological testing and advances in anesthesiology. Until recently, the need for IONM services has been limited to large academic hospitals, but the demand for neurophysiologists with expertise in IONM has grown rapidly across diverse types of hospital. The primary goal of the Korean Society of Intraoperative Neurophysiological Monitoring (KSION) is to promote the development of IONM research groups and to contribute to the improvement of fellowship among members and human health through academic projects. These guidelines are based on extensive literature reviews, recruitment of expert opinions, and consensus among KSION board members. This version of the guidelines was fully approved by the KSION, Korean Association of EMG Electrodiagnostic Medicine, the Korean Society of Clinical Neurophysiology, the Korean Academy of Rehabilitation Medicine, and the Korean Neurological Association.

• 한국환경보건학회지
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• 제46권4호
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• pp.410-422
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• 2020

Objectives: According to the Act on Registration, Evaluation, Etc. of Chemicals, new and existing chemicals must be registered by 2030. In addition, industries need to submit hazard data as an attachment during the registration process. Therefore, we constructed a nationwide chemical database to support small industry by providing hazard data and original sources. During the process, we developed a new standard procedure for minimizing errors and increasing reliability. Methods: We analyzed the categories of errors and the cause of the errors through the verification results of the 2019 project. We present an improved database construction methodology and system. Results: Errors are categorized according to their causative factors into simple, technical, and structural type errors. Simple errors arise simply because of decreased concentration or negligence in following the instructions. Technical errors are caused by a discrepancy between the professional field and the type of data. Structural errors indicate systemic errors such as incomplete forms on the excel database or ambiguity in the guidelines. Lessons from the errors collected in the 2019 project are used to update the procedures for database authorization and technical guidelines. The main update points are as follows; 'supplementation of review process', 'giving regular training to external reviewers', 'giving additional information to authors, like physico-chemical properties of substances, degradability, etc.', 'amendment of excel form', and 'guideline upgrades'. Conclusions: We conducted this study with the aim of improving the accuracy and reliability of the database of hazard information for chemical substances. The new procedures and guidelines are now being used in the 2020 project for construction of a hazard information database for Korea.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8595-8598
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• 2016

Background: Decision making modalities for screening for many cancer conditions and different stages have become increasingly complex. Computer-based risk assessment systems facilitate scheduling and decision making and support the delivery of cancer screening services. The aim of this article was to survey electronic risk assessment system as an appropriate tool for the prevention of cancer. Materials and Methods: A qualitative design was used involving 21 face-to-face interviews. Interviewing involved asking questions and getting answers from exclusive managers of cancer screening. Of the participants 6 were female and 15 were male, and ages ranged from 32 to 78 years. The study was based on a grounded theory approach and the tool was a semi-structured interview. Results: Researchers studied 5 dimensions, comprising electronic guideline standards of colorectal cancer screening, work flow of clinical and genetic activities, pathways of colorectal cancer screening and functionality of computer based guidelines and barriers. Electronic guideline standards of colorectal cancer screening were described in the s3 categories of content standard, telecommunications and technical standards and nomenclature and classification standards. According to the participations' views, workflow and genetic pathways of colorectal cancer screening were identified. Conclusions: The study demonstrated an effective role of computer-guided consultation for screening management. Electronic based systems facilitate real-time decision making during a clinical interaction. Electronic pathways have been applied for clinical and genetic decision support, workflow management, update recommendation and resource estimates. A suitable technical and clinical infrastructure is an integral part of clinical practice guidline of screening. As a conclusion, it is recommended to consider the necessity of architecture assessment and also integration standards.

• 융합정보논문지
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• 제9권3호
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• pp.1-7
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• 2019

업무용 PC에 다양한 사이버 공격이 발생하고 있다. PC 보안 위협을 줄이기 위해 사전에 취약점 진단을 통해서 예방하고 있다. 하지만 국내의 취약점 가이드는 진단 항목이 업데이트되지 않아서 이 가이드로만은 대응하기가 어렵다. 본 논문에서는 최근 PC의 사이버 침해사고 사례와 보안 위협에 대응하기 위한 국외의 기술적 취약점 진단 항목에 대해서 살펴본다. 또한, 국외와 국내의 기술적 취약점 진단항목의 차이를 비교하여 개선된 가이드를 제시한다. 제안한 41개의 기술적 취약점 개선 항목을 통하여 다양한 보안 위협으로부터 대응할 수 있다는 것을 알 수 있었다. 현재는 알려진 취약점에만 주로 대응이 가능하지만 이 방법의 가이드 적용을 통해 알려지지 않은 보안 위협을 감소시킬 수 있을 것으로 기대한다.