• Tuberculosis and Respiratory Diseases
• /
• v.76 no.3
• /
• pp.105-113
• /
• 2014

From January 2012 up until March 2013, many articles with huge clinical importance in asthma were published based on large numbered clinical trials or meta-analysis. The main subjects of these studies were the new therapeutic plan based on the asthma phenotype or efficacy along with the safety issues regarding the current treatment guidelines. For efficacy and safety issues, inhaled corticosteroid tapering strategy or continued long-acting beta agonists use was the major concern. As new therapeutic trials, monoclonal antibodies or macrolide antibiotics based on inflammatory phenotypes have been under investigation, with promising preliminary results. There were other issues on the disease susceptibility or genetic background of asthma, particularly for the "severe asthma" phenotype. In the era of genome and pharmacogenetics, there have been extensive studies to identify susceptible candidate genes based on the results of genome wide association studies (GWAS). However, for severe asthma, which is where most of the mortality or medical costs develop, it is very unclear. Moreover, there have been some efforts to find important genetic information in order to predict the possible disease progression, but with few significant results up until now. In conclusion, there are new on-going aspects in the phenotypic classification of asthma and therapeutic strategy according to the phenotypic variations. With more pharmacogenomic information and clear identification of the "severe asthma" group even before disease progression from GWAS data, more adequate and individualized therapeutic strategy could be realized in the future.

• Journal of the Korean Society of Environmental Restoration Technology
• /
• v.13 no.5
• /
• pp.90-105
• /
• 2010

Because of various stresses with rapid change of social structure, the number of the disabled increase steadily. So, the interest of touch garden which the disabled interact with nature and communicate with the non-disabled is more in demand. This study carried out a survey for landuse, facilities, therapeutic garden in creating touch gardens targeting the disabled using them. The results are as follows: At first, the appropriate natural facilities can lead return visit of the disabled. The second, general facilities for information and barrier-free are insufficient. The third, the disabled demand more places for sense of touch and vision, and, also they demand more places for feeling various living things and sense of the season. And the last, the disabled have no experience in therapeutic gardens, but they have consensus for creating special places for the disabled. This study carried out a survey for specially designated user such as the disabled, but through it, it is expected to establish developed design guidelines for creating touch gardens and therapeutic gardens.

• The Korean Journal of Applied Statistics
• /
• v.22 no.2
• /
• pp.317-327
• /
• 2009

In adaptive designs important components of clinical trials may be changed based on the results of interim analysis. Several international guidelines point out that such interim analysis should be performed by independent experts who do not participate in clinical trials when adaptive designs are used in therapeutic confirmatory clinical trials, and if not, it may cause bias. The international guidelines recommend the establishment of independent data monitoring committee for conducting interim analysis independently.

• Tuberculosis and Respiratory Diseases
• /
• v.78 no.3
• /
• pp.168-174
• /
• 2015

Drug-resistant tuberculosis (TB) is still a major threat worldwide. However, recent scientific advances in diagnostic and therapeutic tools have improved the management of drug-resistant TB. The development of rapid molecular testing methods allows for the early detection of drug resistance and prompt initiation of an appropriate treatment. In addition, there has been growing supportive evidence for shorter treatment regimens in multidrug-resistant TB; and for the first time in over 50 years, new anti-TB drugs have been developed. The World Health Organization has recently revised their guidelines, primarily based on evidence from a meta-analysis of individual patient data (n=9,153) derived from 32 observational studies, and outlined the recommended combination and correct use of available anti-TB drugs. This review summarizes the updated guidelines with a focus on the medical management of drug-resistant TB.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.24 no.5
• /
• pp.413-422
• /
• 2021

Intestinal lymphangiectasia is a rare disease which is causing protein-losing enteropathy. Treatment of intestinal lymphangiectasia can be a challenge for clinicians because of the lack of specific guidelines regarding pharmacological indications. We sought to introduce a diagnostic approach and suggest guidelines for treatment. After exclusion of secondary intestinal lymphangiectasia, magnetic resonance lymphangiography is a promising tool for the assessment of abnormal lymphatic lesions in primary intestinal lymphangiectasia. Determining the extent of the lesion provides direction for treatment options. Focal short-segment intestinal lymphangiectasia can be treated via intestinal resection or radiologic embolization after dietary therapy failure. Diffuse intestinal lymphangiectasia and extensive lymphangiectasia should be treated with several drugs with a full understanding of their mechanisms.

• Journal of Korean Neurosurgical Society
• /
• v.66 no.3
• /
• pp.298-307
• /
• 2023

Remarkable advances in neonatal care have significantly improved the survival of extremely low birth weight infants in recent years. However, intraventricular hemorrhage (IVH) continues to be a major complication in preterm infants, leading to a high incidence of cerebral palsy and cognitive impairment. IVH is primarily caused by disruption of the fragile vascular network of the subependymal germinal matrix, and subsequent ventricular dilatation adversely affects the developing infant brain. Based on recent research, periventricular white matter injury is caused not only by ischemia and morphological distortion due to ventricular dilatation but also by free iron and inflammatory cytokines derived from hematoma and its lysates. The current guidelines for the treatment of posthemorrhagic hydrocephalus (PHH) in preterm infants do not provide strong recommendations, but initiating treatment intervention based on ultrasound measurement values before the appearance of clinical symptoms of PHH has been proposed. Moreover, in the past decade, therapeutic interventions that actively remove hematomas and lysates have been introduced. The era is moving beyond cerebrospinal fluid shunt toward therapeutic goals aimed at improving neurodevelopmental outcomes.

• Clinical Endoscopy
• /
• v.55 no.4
• /
• pp.473-479
• /
• 2022

Over the last few years, capsule endoscopy has been established as a fundamental device in the practicing gastroenterologist's toolbox. Its utilization in diagnostic algorithms for suspected small bowel bleeding, Crohn's disease, and small bowel tumors has been approved by several guidelines. The advent of double-balloon enteroscopy has significantly increased the therapeutic possibilities and release of multiple devices (single-balloon enteroscopy and spiral enteroscopy) aimed at improving the performance of small bowel enteroscopy. Recently, some important innovations have appeared in the small bowel endoscopy scene, providing further improvement to its evolution. Artificial intelligence in capsule endoscopy should increase diagnostic accuracy and reading efficiency, and the introduction of motorized spiral enteroscopy into clinical practice could also improve the therapeutic yield. This review focuses on the most recent studies on artificial-intelligence-assisted capsule endoscopy and motorized spiral enteroscopy.

• Tuberculosis and Respiratory Diseases
• /
• v.67 no.6
• /
• pp.491-498
• /
• 2009

Severe sepsis and septic shock are major healthcare problems with high mortality, ranging from 20% to 60%, affecting millions of individuals around the world each year. The speed and appropriateness of therapy administered in the initial hours after severe sepsis develops have an important impact on the outcome. In 2004, an international guideline that the bedside clinician could use to improve the outcomes in severe cases of sepsis and septic shock was published. Several landmark studies recently demonstrated that therapeutic strategies may reduce mortality substantially. The "Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock: 2008", using a new evidence-based methodology system for assessing the quality of evidence and the strength of the recommendations, was updated. The revised version is based on an updated search into 2007. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improving the outcomes of critically ill patients. We review the treatment guidelines of sepsis and septic shock.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.16 no.1
• /
• pp.91-105
• /
• 2021

Objectives A case report is a detailed medical description of previously unreported observations or complications of medical conditions, unique use cases of tests, or new side effects. The purpose of this study was to evaluate the quality of case reports published in the Journal of Korea CHUNA Manual Medicine for Spine & Nerves (JKCMSN). Methods Case reports published in the JKCMSN from January 2013 to December 2020 were selected using the Oriental Medicine Advanced Searching Integrated System (OASIS). The quality of the reports was assessed based on the Consensus-based Clinical Case Reporting Guideline Development (CARE) guidelines. Results Sixty case reports that met the inclusion criteria were included in the assessment. Our analysis revealed that 71.42% of the case reports included all the necessary information and their level of reporting was good. However, their scores in the qualitative subdivisions of the reporting level parameters showed that the quality level was uneven. More than 65% of the papers did not report in the following categories: "Keywords," "Patient information," "Timeline," "Diagnostic assessment," "Therapeutic interventions," "Follow-up and outcomes," "Patient perspective," and "Informed consent." Conclusions Our analysis shows that CARE guidelines need to be followed more rigorously to improve the quality of reporting in the JKCMSN. Further efforts are necessary to develop reporting guidelines and evaluation tools relevant to the Korean clinical context.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.36 no.2
• /
• pp.1-9
• /
• 2023

Objectives : This study used a network pharmacology approach to analyze the treatment mechanisms of Yijin-tang on Meniere's disease, and comparative analysis the treatment mechanisms of drugs recommended in the Meniere's disease treatment guidelines. Methods : We collected information on the recommended drugs from the Meniere's disease treatment guidelines and their target proteins were screened via the STITCH database. The intersection targets were obtained through Venny 2.1.0. Gene Ontology(GO) analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway analysis were performed using ClueGO. Results : The 7 proteins(TNF, CASP9, PARP1, CCL2, CFTR, NOS2, NOS1) were associated with both Yijin-tang and Meniere's disease related genes. The 10 proteins(AQP2, KCNE1, AQP1, AVP, ACE, HRH1, HRH3, NOS1, CA1, CFTR) were associated with both the recommended drugs in the guidelines and Meniere's disease related genes. The 2 proteins(CFTR, NOS1) were common across all three groups. Further, GO/KEGG pathway analysis of the collected proteins revealed that the common mechanisms of action between Yijin-tang and the recommended drugs in the guidelines were related to pathways involving immune dysfunction and disturbances in lymphatic fluid homeostasis. In addition, the recommended drugs in the guidelines appeared to act through mechanisms that improve blood flow through vasodilation. Conclusions : Pharmacological network analysis can help to explain the treatment mechanisms of Yijin-tang on Meniere's disease.