• Title/Summary/Keyword: Korean medicine clinical practice guidelines

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The Reappraisal and Appropriate Use of Benzodiazepine (Benzodiazepine의 재평가 및 적절한 사용)

  • Park Sung-Hyouk;Kim Chan-Hyung
    • Anxiety and mood
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    • v.1 no.1
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    • pp.31-36
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    • 2005
  • Benzodiazepine (BDZ) has the possibilities of development of tolerance, withdrawal symptoms, and abuse/addiction, as well as chronically adverse effects. Although many guidelines have proposed the restricted prescription of them, their uses in many psychiatric areas as well as primary practice are still wide spread. So we tried to reappraise the clinical characteristics of BDZ and then to consider the appropriate use. Firstly, meta-analyses on long-term use of BDZ indicated the cognitive impairment, which could be improved after discontinuation of BDZ. Next, there have been some evidences that the long-term use of BDZ does not develop tolerance, contrary to our concern, and maintains good anxiolytic effects. Also, physiological dependence should be discriminated from abuse/addiction, assuming the reality that the risk of BDZ abuse/addiction is surely overestimated. These issues are discussed in detail.

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Being a front-line dentist during the Covid-19 pandemic: a literature review

  • Fallahi, Hamid Reza;Keyhan, Seied Omid;Zandian, Dana;Kim, Seong-Gon;Cheshmi, Behzad
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.12.1-12.9
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    • 2020
  • Coronavirus is an enveloped virus with positive-sense single-stranded RNA. Coronavirus infection in humans mainly affects the upper respiratory tract and to a lesser extent the gastrointestinal tract. Clinical symptoms of coronavirus infections can range from relatively mild (similar to the common cold) to severe (bronchitis, pneumonia, and renal involvement). The disease caused by the 2019 novel coronavirus (2019-nCoV) was called Covid-19 by the World Health Organization in February 2020. Face-to-face communication and consistent exposure to body fluids such as blood and saliva predispose dental care workers at serious risk for 2019-nCoV infection. As demonstrated by the recent coronavirus outbreak, information is not enough. During dental practice, blood and saliva can be scattered. Accordingly, dental practice can be a potential risk for dental staff, and there is a high risk of cross-infection. This article addresses all information collected to date on the virus, in accordance with the guidelines of international health care institutions, and provides a comprehensive protocol for managing possible exposure to patients or those suspected of having coronavirus.

Development of medical genetics training program and certification process for medical geneticist as a specialist in Korea (의학유전학 전문인력 교육프로그램의 개발과 인증에 관한 연구)

  • Yoo, Han-Wook;Hwang, Do-yeong;Ryu, Hyun-Mee;Lee, Hong-Jin;Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.4 no.2
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    • pp.142-159
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    • 2007
  • Purpose : This study was undertaken to provide prerequisites for accreditation of medical genetics training program and certification process for medical genetics professionals as clinical specialist and set up guidelines on curriculum of medical genetics training program in Korea. Methods : Six ad hoc committees for clinical geneticist, clinical cytogeneticist, clinical molecular geneticist, clinical biochemical geneticist, medical genetics technologists and genetic counselors were organized for reviewing current status in Korea as well as foreign countries. Each committee is composed of 6-8 members. They summarized their opinions according to the structured questionnaire inquiring the ways of accrediting training program, qualification of program director, trainee requirements, contents of curriculum, duration of training program, certification process, estimation of numbers of each specialist needed in next 5 years in Korea. Results : Both prerequisites for the accreditation of medical geneticist training institutions and qualification of program director are suggested. Candidacy of trainees requires MD with board of medical specialty, or PhD degree with professional experiences in related field except clinical genetics program which only accepts MD with board of medical specialty, and Non-MD genetic counselor and medical technologists with degrees of BS or MS. General duration of fellowship will be 2-3 years depending on the categories they are enrolled into. Contents of curriculum for each speciality training are described. For the certification of each category, the candidacy should submit a log book detailing the cases they experienced during the fellowship, prove that they successfully completed course work and clinical experiences in the accredited program, and pass the written examination. Conclusion : As medical genetics becomes more important in daily routine clinical practice, the accreditation of medical genetics training program and certification of personnel are urgently needed. In this regard, the study will be providing guidelines and prerequisites for accreditation of medical genetics training program and certification process for medical genetics professionals as clinical specialist.

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Development and Evaluation of an Evidence-based Nursing Protocol for Postoperative Nausea and Vomiting (근거기반의 수술 후 오심·구토 관리 프로토콜의 개발 및 임상적 평가)

  • Oh, In Ohg;Yoo, Jae Yong;Oh, Eui Geum
    • Journal of Korean Biological Nursing Science
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    • v.19 no.2
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    • pp.86-97
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    • 2017
  • Purpose: Postoperative nausea and vomiting (PONV) is very common among postoperative orthopedic surgical patients with patient-controlled analgesia (PCA), especially for narcotics. Therefore, the purpose of this study was to investigate the effects of an evidence-based PONV management protocol on nursing and patient outcomes. Methods: A methodological study was conducted to develop PONV protocol and a quasi-experimental study to evaluate the effectiveness of protocol. The preliminary PONV protocol was drawn by conducting a systematic review and by reviewing clinical guidelines and best practice recommendations. Validation of the content was done by expert clinicians, and the clinical applicability was evaluated by staff nurses and patients. The effect was evaluated in clinical outcomes associated with PONV and nursing outcomes. Results: In the experimental group, the occurrence of vomiting (z= 2.147) was significantly decreased, the maintenance PCA (${\chi}^2=4.212$) and the satisfaction of patients (z= 5.007) were significantly higher. In the outcomes of nurses, the PONV knowledge of nursing care (z = 3.791), awareness (z = 2.982) and self-efficacy (z= 2.745) were higher in the experimental group. The attitude towards evidence-based nursing practice (z= 2.446) was significantly positive. Conclusion: The results show that an evidence-based approach to the implementation of PONV care is effective in improving patient clinical outcomes and quality of care.

Appropriateness of Labelling Practice for Pesticides in Korea (국내 농약 제품표지 내용 및 유독성 표시의 적절성)

  • Oh Bum Jin;Roh Hyung-Keun;Kim Won;Cho Gyu Chong;Shon Yoo Dong;Kang Hui Dong;Lim Kyoung Soo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.2
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    • pp.71-78
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    • 2005
  • Purpose: The morbidity of pesticides are largely related with accidental ingestion in human. The four principal ideals of clarity, completeness, conformity and consistency of label are important to make a correct usage and prevent unnecessary health risk. The aim of this study is to evaluate the appropriateness of pesticides labelling practice in Korea. Methods: The photographic label images of pesticide products were gathered through visiting thirteen manufacturers that produce pesticide products in Korea. We scored labelling practice by guidelines of Food and Agriculture Organization of the United Nations in 1995. Results: From August 2005 to November 2005, we gathered 1,296 label images of pesticide and $58.3{\%}$ (755/1,296) of images were scored by check lists for reviewing label content. The average score of four check list categories was $71.9{\pm}2.2$. Each categorical score were $91.7{\pm}0.9$ for the information appearing on the label, $31.3{\pm}0.0$ for safety precaution, $77.7{\pm}2.0$ for instructions for use, $87.0{\pm}8.7$ for general configurations. In safety precaution, the sentence of keeping locked up the product and two mandatory safety pictograms were missed in all label images. In general configurations category, there was score difference in product package types between bottle and bag container ($85.1{\pm}9.0$ vs. $90.3{\pm}7.2$, p < 0.01). Conclusion: Although there was no comparable previous data, the score of safety precaution was lowest than other categories because the two mandatory safety pictograms and locked up warning sentence were missed. In general configurations, the colour contrast was more inappropriate in the labels on bottle than bag container.

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Intravenous immunoglobulin G in women with reproductive failure: The Korean Society for Reproductive Immunology practice guidelines

  • Sung, Nayoung;Han, Ae Ra;Park, Chan Woo;Park, Dong Wook;Park, Joon Cheol;Kim, Na Young;Lim, Kyung Sil;Shin, Ji Eun;Joo, Chang Woo;Lee, Seung Eun;Kim, Jae Won;Lee, Sung Ki;IVIG Task Force Korean Society for Reproductive Immunology
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.1
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    • pp.1-7
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    • 2017
  • The task force of the Korean Society for Reproductive Immunology recommends intravenous immunoglobulin G treatment in women with reproductive failure, including recurrent pregnancy loss and/or repeated implantation failure, who show cellular immune factors such as abnormal natural killer cell levels, natural killer cell cytotoxicity, and/or type 1 T helper immunity.

Herbal Medicine for Tension-type Headache: Systematic Review and Meta Analysis of Randomized Controlled Trials (긴장성두통에 대한 한약치료: 체계적 문헌고찰 및 메타분석)

  • Choi, Eun-Ji;Kwon, Chan-Young;Han, Kyung-Hun;Kim, Jong-Woo;Chung, Sun-Young
    • Journal of Oriental Neuropsychiatry
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    • v.26 no.4
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    • pp.383-406
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    • 2015
  • Objectives: People with tension-type headache generally take pain relievers, but long term dependency causes problems as well as side effects. The present study aimed to provide clinical evidence of herbal medicine for tension-type headache by systematic review of randomized controlled trials on the effect of herbal medicine for tension-type headache. Methods: Randomized or quasi-randomized controlled trials that verified effects of herbal medicine intervention on patients with tension-type headache were included in the study. A literature search of English, Japanese, Chinese, Korean databases was performed. The selected literature were assessed by Jadad scale and Risk of Bias. Results: Herein, 40 reports were selected from a total of 157. Meta-analyses of 2 trials indicated that the effective rate was significantly higher in the herbal medicine treatment group, as compared to the placebo control (risk ratio: 1.49, 95% confidence interval (CI): 1.23 to 1.80, p<0.0001, I2=0%). Four trials that compared herbal medicine with routine care with routine care only group showed a significantly higher effective rate of benefits for herbal medicine with routine care, as compared to routine care only (RR: 1.57, 95% CI: 1.18 to 2.10, p=0.002, I2=0%). Conclusions: The effective rate was significantly higher than control and adverse events were less in the treatment group. Pattern analysis (辨證) indicated that the studies on wind-fire pattern (風火證) were highest. Yougeun-bang (柔筋方) in prescription and Paeoniae Radix Alba (白芍藥) in medicinal herbs were most used. This finding could be widely utilized in future clinical practice and form the basis for the development of clinical practice guidelines in advance.

Gadoxetate-Enhanced MRI as a Diagnostic Tool in the Management of Hepatocellular Carcinoma: Report from a 2020 Asia-Pacific Multidisciplinary Expert Meeting

  • Cher Heng Tan;Shu-cheng Chou;Nakarin Inmutto;Ke Ma;RuoFan Sheng;YingHong Shi;Zhongguo Zhou;Akira Yamada;Ryosuke Tateishi
    • Korean Journal of Radiology
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    • v.23 no.7
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    • pp.697-719
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    • 2022
  • Gadoxetate magnetic resonance imaging (MRI) is widely used in clinical practice for liver imaging. For optimal use, we must understand both its advantages and limitations. This article is the outcome of an online advisory board meeting and subsequent discussions by a multidisciplinary group of experts on liver diseases across the Asia-Pacific region, first held on September 28, 2020. Here, we review the technical considerations for the use of gadoxetate, its current role in the management of patients with hepatocellular carcinoma (HCC), and its relevance in consensus guidelines for HCC imaging diagnosis. In the latter part of this review, we examine recent evidence evaluating the impact of gadoxetate on clinical outcomes on a continuum from diagnosis to treatment decision-making and follow-up. In conclusion, we outline the potential future roles of gadoxetate MRI based on an evolving understanding of the clinical utility of this contrast agent in the management of patients at risk of, or with, HCC.

Common viral infections in kidney transplant recipients

  • Vanichanan, Jakapat;Udomkarnjananun, Suwasin;Avihingsanon, Yingyos;Jutivorakool, Kamonwan
    • Kidney Research and Clinical Practice
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    • v.37 no.4
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    • pp.323-337
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    • 2018
  • Infectious complications have been considered as a major cause of morbidity and mortality after kidney transplantation, especially in the Asian population. Therefore, prevention, early detection, and prompt treatment of such infections are crucial in kidney transplant recipients. Among all infectious complications, viruses are considered to be the most common agents because of their abundance, infectivity, and latency ability. Herpes simplex virus, varicella zoster virus, Epstein-Barr virus, cytomegalovirus, hepatitis B virus, BK polyomavirus, and adenovirus are well-known etiologic agents of viral infections in kidney transplant patients worldwide because of their wide range of distribution. As DNA viruses, they are able to reactivate after affected patients receive immunosuppressive agents. These DNA viruses can cause systemic diseases or allograft dysfunction, especially in the first six months after transplantation. Pretransplant evaluation and immunization as well as appropriate prophylaxis and preemptive approaches after transplant have been established in the guidelines and are used effectively to reduce the incidence of these viral infections. This review will describe the etiology, diagnosis, prevention, and treatment of viral infections that commonly affect kidney transplant recipients.

오행침자법(五行鍼刺法) 원리 및 임상응용에 관한 연구 - I 원리에 관한 연구

  • Ahn, Chang-Beohm;Jang, Kyung-Jun;Yoon, Hyun-Min;Kim, Cheol-Hong;Min, Young-Kwang;Moon, Hyuck-Chol;Koo, Sung-Tae
    • Journal of Pharmacopuncture
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    • v.11 no.3
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    • pp.17-31
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    • 2008
  • Objective: To review the theoretic basis of the Sa-Ahm 5 Element acupuncture devised about 360 years ago, papers and books were researched. Methods: Total of 59 books and papers ranging from ancient Huang Di nei jing to modern Bio Medical Acupuncture for Pain Management were researched to study the basic theory of it in relation to the 5 Shu points, Results: Gao-mu in Chinese Ming dynasty, for the 1st time, had used 5 Shu points based on creation cycle as tonification and sedation treatment respectively and named it as 'tonification and sedation treatment of self meridian' but since then, this method, without special reasons, has been rarely used until Sa-Ahm's new doctrine that include the concept of destruction cycle was asserted. Conclusions: Sa-Ahm 5 Element acupuncture is a method which uses 5 Shu points from the viewpoints of simultaneous tonification and sedation methods which are based on promotion and control cycles. Though it is nowadays mostly-used method in accordance with practitioner's points, it needs to be set guidelines by which to effectively practice Sa-Ahm acupuncture.