• Tuberculosis and Respiratory Diseases
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• 제84권4호
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• pp.263-273
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• 2021

Cough is the most common respiratory symptom that can have various causes. It is a major clinical problem that can reduce a patient's quality of life. Thus, clinical guidelines for the treatment of cough were established in 2014 by the cough guideline committee under the Korean Academy of Tuberculosis and Respiratory Diseases. From October 2018 to July 2020, cough guidelines were revised by members of the committee based on the first guidelines. The purpose of these guidelines is to help clinicians efficiently diagnose and treat patients with cough. This article highlights the recommendations and summary of the revised Korean cough guidelines. It includes a revised algorithm for the evaluation of acute, subacute, and chronic cough. For a chronic cough, upper airway cough syndrome (UACS), cough variant asthma (CVA), and gastroesophageal reflux disease (GERD) should be considered in differential diagnoses. If UACS is suspected, first-generation antihistamines and nasal decongestants can be used empirically. In cases with CVA, inhaled corticosteroids are recommended to improve cough. In patients with suspected chronic cough due to symptomatic GERD, proton pump inhibitors are recommended. Chronic bronchitis, bronchiectasis, bronchiolitis, lung cancer, aspiration, intake of angiotensin-converting enzyme inhibitor, intake of dipeptidyl peptidase-4 inhibitor, habitual cough, psychogenic cough, interstitial lung disease, environmental and occupational factors, tuberculosis, obstructive sleep apnea, peritoneal dialysis, and unexplained cough can also be considered as causes of a chronic cough. Chronic cough due to laryngeal dysfunction syndrome has been newly added to the guidelines.

• Annals of Clinical Neurophysiology
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• 제19권2호
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• pp.118-124
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• 2017

Electroencephalography (EEG) is frequently used to assist the diagnosis of brain death. However, to date there have been no guidelines in terms of EEG criteria for determining brain death in Korea, despite EEG being mandatory. The purpose of this review is to provide an update on the evidence and controversies with regarding to the utilization of EEG for determining brain death and to serve as a cornerstone for the development of future guidelines. To determine brain death, electrocerebral inactivity (ECI) should be demonstrated on EEG at a sensitivity of $2{\mu}V/mm$ using double-distance electrodes spaced 10 centimeters or more apart from each other for at least 30 minutes, with intense somatosensory or audiovisual stimuli. ECI should be also verified by checking the integrity of the system. Additional monitoring is needed if extracerebral potentials cannot be eliminated. Interpreting EEG at high sensitivities, which is required for the diagnosis of brain death, can pose a diagnostic challenge. Furthermore, EEG is affected by physiologic variables and drugs. However, no consensus exists as to the minimal requirements for blood pressure, oxygen saturation, and body temperature during the EEG recording itself, the minimal time for observation after the brain injury or rewarming from hypothermia, and how to determine brain death when the findings of ECI is equivocal. Therefore, there is a strong need to establish detailed guidelines for performing EEG to determine brain death.

• Neonatal Medicine
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• 제18권2호
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• pp.345-352
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• 2011

목적: 신생아중환자실은 간호 요구도가 높은 곳으로 간호 수준이 환자 결과에 영향을 미치는 것으로 알려져 있다. 저자들은 신생아중환자실에서 간호 숙련성의 차이에 따른 위해 사건의 차이를 비교하고 간호 위해 사건에 대한 예방 지침 마련 후 위해 사건의 변화를 알고자 하였다. 방법: 새로 설립된 A병원과 14 년간 운영되어 온 B병원의 신생아중환자실을 대상으로 2009년 1월 1일부터 2009년 12월 31일 까지 1년간의 간호 위해 사건과 당시 근무한 간호 인력의 경력을 조사하였다. 그리고 A병원에서 간호 위해 사건 예방을 위한 지침을 마련한 후 1년 뒤의 사고 변화를 조사하였다. 결과: A병원의 간호 인력은 2년 이내 경력자가 20명(80%)인 반면 B병원의 간호 인력은 2년 이상 4년 미만의 경력자가 13명(65%)으로 많아 간호 숙련성에 있어 유의한 차이가 있었다(P<0.001). 2009년도에 확인된 간호 위해 사건은 A병원에서 46건, B병원에서 10건으로 전체적으로 A병원에서 많이 발생했고 두 병원에서 정맥주사 관련 사고가 각각 24건(52.2%), 8건(80%)으로 가장 많은 비율을 차지했다. 위해 사건 예방을 위한 간호 지침 마련 후 2010년도에 확인된 간호 위해 사건은 17건으로 총 발생빈도가 감소하였으며 정맥 주사 관련 사고가 6건(35%)으로 가장 많았으나 비율이 감소하였음을 확인하였다. 결론: 간호 숙련성이 높을수록 위해 사건의 빈도가 적었고 위해 사건을 예방하기 위한 지침 마련 후 사고 빈도가 감소함을 확인하였다. 예방 가능한 간호 위해 사건의 빈도를 줄이기 위하여 자체적인 감시와 예방 지침의 강구가 필요하며 이는 중환자실 서비스의 질을 높이는 방법이 될 것이다.

• Toxicological Research
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• 제30권4호
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• pp.251-260
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• 2014

The number of farmers who have suffered from non-fatal acute pesticide poisoning has been reported to vary from 5.7% to 86.7% in South Korea since 1975. Absorption through the skin is the main route of exposure to pesticides for farmers who operate with them. Several in vitro tests using the skins of humans or animal and in vivo tests using laboratory animals are introduced for the assessment of human dermal absorption level of pesticides. The objective of this study is to evaluate and compare international guidelines and strategies of dermal absorption assessments and to propose unique approaches for applications into pesticide registration process in our situation. Until present in our situation, pesticide exposure level to operator is determined just using default value of 10 as for skin absorption ratio because of data shortage. Dermal absorption tests are requested to get exposure level of pesticides and to ultimately know the safety of pesticides for operators through the comparison with the value of AOEL. When the exposure level is higher than AOEL, the pesticide cannot be approved. We reviewed the skin absorption test guidelines recommended by OECD, EFSA and EPA. The EPA recommends assessment of skin absorption of pesticides for humans through the TPA which includes all the results of in vitro human and animal and animal in vivo skin absorption studies. OECD and EFSA, employ a tiered approach, which the requirement of further study depends on the results of the former stage study. OECD guidelines accept the analysis of pesticide level absorbed through skin without radioisotope when the recovery using the non-labeled method is within 80~120%. Various factors are reviewed in this study, including the origin of skin (gender, animal species and sites of skin), thickness, temperature and, etc., which can influence the integrity of results.

• 대한골대사학회지
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• 제25권4호
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• pp.195-211
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• 2018

Background: To develop guidelines and recommendations to prevent and treat glucocorticoid (GC)-induced osteoporosis (GIOP) in Korea. Methods: The Korean Society for Bone and Mineral Research and the Korean College of Rheumatology have developed this guideline based on Guidance for the Development of Clinical Practice Guidelines ver. 1.0 established by the National Evidence-Based Healthcare Collaborating Agency. This guideline was developed by adapting previously published guidelines, and a systematic review and quality assessment were performed. Results: This guideline applies to adults aged ${\geq}19years$ who are using or plan to use GCs. It does not include children and adolescents. An initial assessment of fracture risk should be performed within 6 months of initial GC use. Fracture risk should be estimated using the fracture-risk assessment tool (FRAX) after adjustments for GC dose, history of osteoporotic fractures, and bone mineral density (BMD) results. All patients administered with prednisolone or an equivalent medication at a dose ${\geq}2.5mg/day$ for ${\geq}3months$ are recommended to use adequate calcium and vitamin D during treatment. Patients showing a moderate-to-high fracture risk should be treated with additional medication for osteoporosis. All patients continuing GC therapy should undergo annual BMD testing, vertebral X-ray, and fracture risk assessment using FRAX. When treatment failure is suspected, switching to another drug should be considered. Conclusions: This guideline is intended to guide clinicians in the prevention and treatment of GIOP.

• 한국간담췌외과학회지
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• 제28권2호
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• pp.161-202
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• 2024

Backgrounds/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions: The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

• 경영과학
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• 제11권2호
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• pp.207-235
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• 1994

Regarding the study in innovation/R&D programs evaluation, twelve cases from the U.S ., U. K., Germany, France, Sweden, Australia, Japan, and EC are analyzed, and its implications to Korean situation are investigated. From the analysis of the cases, some valuable guidelines for Korea are developed. Some of the guidelines are: the evaluation must be treated as an integral part of the Government supported programs, specialists in evaluation should be raised, the long-term effects and non-economic/social effects should also be included in the evaluation, various efforts to acquire more exact and versatile information necessary for quality evaluation should be made, and additional effort is required for the evaluation to be actualized.

• 중환자간호학회지
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• 제2권2호
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• pp.68-78
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• 2009

Evidence based clinical practice guideline are designed to help healthcare practitioners evaluate and implement the increasing amount of evidence on best practice. Critical care area is one of the clinical sites where evidence based clinical practice guideline is needed most. This paper reviewed the definition of evidence based clinical practice guidelines, the development method of evidence based clinical practice guideline, and the current trends in guideline developing. Traditional method of guideline development is consensus based but it moves into evidence based development. Evidence based guideline is based on best available evidence and uses the strongest method to determine its effect on clinical outcomes. The current trends in guidelines is to develop the guideline at regional/national level and do subsequent modification to suit local circumstances. There is an urgent need of exploring the method of guideline development and adaptation which are appropriate for Korean clinical setting.

• 한국건설관리학회논문집
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• 제17권2호
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• pp.12-20
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• 2016

국가회계의 발전과 더불어 자산의 체계적인 관리 중요성이 강조되고 있으며, 건설 분야에서도 자산관리라는 개념을 도입하여 시설물을 관리해야 한다는 인식이 높아지고 있다. 이 연구는 자산관리 개념 도입을 위한 기초적 연구로서 유지관리비 회계처리를 명확하게 할 수 있는 공공건축물 유지관리 회계처리 실무지침(안)을 제안하였다. 기존 문헌과 현행 회계처리 기준을 조사하였으며, A광역시의 공공건축물을 대상으로 유지관리비 회계처리 실태를 조사하여 문제점을 도출하였다. 실무지침(안)에서는 청사 유지관리비 지출 유형과 내용을 분석하였으며, OPEX와 CAPEX로 처리해야할 항목을 제시하였다. 제시한 항목의 신뢰성을 검증하기 위해 전문가 면담을 실시하였다. A광역시의 공공건축물 유지관리 실적자료를 대상으로 실무지침(안)을 적용하여 자산가액 변동 상황을 파악하였으며, 자산 가치증가에 미치는 영향을 검토하였다. 본 연구에서 제시한 실무지침(안)을 실무에 적용한다면 건물 자산 가치를 증대시키고, 일관된 재무정보를 제공하여 이해관계자들의 의사결정에 도움을 줄 것으로 사료된다.

• 한국BIM학회 논문집
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• 제11권3호
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• pp.55-66
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• 2021

Recently, Building Information Modeling(BIM) has become a hot topic in the construction industry such as quantity calculation, interference check, process management, and construction cost management. It is also trying to convert the existing 2D design to 3D design and introduce the BIM in various fields, thus, many new deliverable are being presented but there are many issues due to the lack of standard guides on the preparation and delivery criteria for such new deliverable and how to utilize performance data. Therefore, In order to develop the electronic delivery process, we analyzed the process related to the delivery of BIM digital models presented in domestic and international BIM guidelines and the delivery of products from the Korea National Railway. The analysis focused on the list of achievements, delivery process, quality review standards, and the utilization code system of the Korea National Railway through BIM guidelines and the National Railroad Service's business procedures. Based on these analysis results, it presents a plan to construct an functional module of electronic delivery.