• Clinical and Experimental Pediatrics
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• 제52권9호
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• pp.976-983
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• 2009

Urinary tract infection (UTI), the most common bacterial disease in childhood, is frequently associated with urinary tract anomalies (15-50%) and can induce renal scarring, which is a cause of hypertension and chronic kidney disease. Despite the high risk of renal scarring in infancy, the diagnosis may be delayed due to its nonspecific presenting symptoms; moreover, over-diagnosis is frequent due to the contamination of urine samples. The delay in diagnosis and treatment may induce sepsis or renal scar, while over-diagnosis is responsible for unnecessary antibiotic treatment and costly urinary imaging studies. UTI guidelines have been ever-changing for the past three decades, but some controversial issues remain. This article is a revision of the previous KSPN (Korean Society of Pediatric Nephrology) guideline and addresses the recent controversies concerning childhood UTI.

• Clinical and Experimental Pediatrics
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• 제61권2호
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• pp.37-42
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• 2018

Hemolytic uremic syndrome (HUS) is often encountered in children with acute kidney injury. Besides the well-known shiga toxin-producing Escherichia coli-associated HUS, atypical HUS (aHUS) caused by genetic complement dysregulation has been studied recently. aHUS is a rare, chronic, and devastating disorder that progressively damages systemic organs, resulting in stroke, end-stage renal disease, and death. The traditional treatment for aHUS is mainly plasmapheresis or plasma infusion; however, many children with aHUS will progress to chronic kidney disease despite plasma therapy. Eculizumab is a newly developed biologic that blocks the terminal complement pathway and has been successfully used in the treatment of aHUS. Currently, several guidelines for aHUS, including the Korean guideline, recommend eculizumab as the first-line therapy in children with aHUS. Moreover, life-long eculizumab therapy is generally recommended. Further studies on discontinuation of eculizumab are needed.

• 동의신경정신과학회지
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• 제24권spc1호
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• pp.3-14
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• 2013

Objectives : Hwabyung Research Center of The Korean Society Of Oriental Neuropsychiatry has attempted to develop 'Clinical Guidelines for the Treatment of Hwabyung' based on the clinical study on the theory of oriental medicine and phenomenological approach. The purpose of this guideline is to establish the basic clinical principles and improve the clinical convenience. Methods : Hwabyung Research Center constructed a committee of experts and advisory group. We extracted the core questions, collected the existing data and evaluated them. Simultaneously, we conducted studies on the major topics. Results : We selected and made suitable tools for the assessment and evaluation. We discovered evidences from clinical studies and developed the standard clinical principles. Conclusions : 'Clinical Guidelines for the Treatment of Hwabyung' is expected to be useful at the primary medical clinics of oriental medicine.

• 한국컴퓨터정보학회논문지
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• 제23권4호
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• pp.115-120
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• 2018

A Clinical Pathway(CP) is standard process to way of treat diseases or injuries which is adapted to each hospital based on National Clinical Practice Guideline(CPG). Since CP is standard guideline for doctors and nurses working in a hospital, making and modifying CP is one of the most important administrational work for hospital and also rare work because once it is fixed, it's not changed whether there are new kind of disease discovered or new treatment is developed. However, in present, patient's waiting time during hospital residence process, is discussed as service competitive for patients. In this research, we utilize process mining tool to verify patients treatment process follows CP with EMR(Electronic Medical Record) in a sample hospital, and suggest modifcation point of CP through verification.

• Journal of Digestive Cancer Research
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• 제4권1호
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• pp.10-16
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• 2016

There were no Korean evidence-based multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework and the recommendation grades were classified as either strong or weak. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. Major limitation of the present guideline is that there is no enough evidences in Korea. Therefore, clinical studies about gastric cancer for evidence generation should be conducted.

• Toxicological Research
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• 제17권3호
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• pp.203-213
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• 2001

We investigated the toxic effects of propylthiouracil (PTU) In Sprague-Dawley (SD) rats to develop and validate an enhanced Protocol for Test Guideline 407 as OECD Project. Twenty male and female SD rats,7 weeks old, were treated with PTU in corn oil at levels of 0, 0.1, 1 and 10 mg/kg/day for 4 weeks orally. Clinical observation, body weight changes, food uptake, water consumption, urinalysis, estrus cycle and sperm analysis, serum chemist교, autopsy findings and histopathological findings were evaluated in this study. No clinical signs and mortality were observed in the study. The body weights and food uptakes in the group treated with 10 mg/kg/day were reduced from 3 weeks after the initiation of the treatment. The levels of 3,5,3'-triiodothyronine (T3) and thyroxine (T4, 3,5,3',5'-tetraiodothyrosine) were also significantly decreased in the group treated with 10 mg/kg/day. Also, the relative and absolute organ weights of thymuses were decreased. Thyroid glands of rats in the group treated with PTU 10 mg/kg/day were bigger than those of rats in the control group. In the histopathological examination, diffuse hyperplasia and hypertrophy of thyroid follicular cells were observed in all treatment groups, leading to the reduction of lumen size and papillary enfolding of lining epithelium. The degree of lesion was increased in a dose-dependent manner. The results suggested that PTU would cause toxicity in thyroid gland and decrease the levels of T3 and T4 in SD rats. However there were no effects on the other organ including testis and uterus especially in spermatogenesis and estrus cycle. On the basis of the results, enhanced protocol for Test Guideline (TG) 407 may be sensitive and reliable to detect endocrine-active substances like PTU.

• Journal of Trauma and Injury
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• 제33권1호
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• pp.1-12
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• 2020

Purpose: Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods: Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results: Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80-90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100-110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient's initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions: This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.

• 대한한의학회지
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• 제41권2호
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• pp.122-136
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• 2020

Objectives: A case report is a detailed report of the symptoms, signs, diagnosis, treatment, and follow-up of an individual patient. The purpose of this study is to evaluate the quality of case reports from the Journal of Korean Medicine by the CARE (CAse REport) Guideline. Methods: Case reports published in the Journal of Korean Medicine from January 2016 to March 2020 were searched from Oriental Medicine Advanced Searching Integrated System (OASIS). We assessed the quality of reporting based on CARE (CAse REport) guideline as 'Sufficient', 'Not-Sufficient' and 'Not-Report'. Results: A total of 22 case reports were finally included for the assessment. The reporting items were reported as of reporting quality. After checking the result, there was a deviation in the sub-item reporting rate by a maximum 89.29%, a minimum 66.67% and a median 82.14% in case reports. Also after checking the quality in case reports by 28 detailed items in CARE guidelines, there were not reported 77% or more in the 5 sub-items 'Intervention adherence and tolerability', 'Informed consent', 'Adverse and unanticipated events', 'Diagnostic challenges', 'Patient perspective'. Conclusion: There is a need to improve the quality of case reports in the journal of Korean Medicine based on various studies using CARE guideline.

• 사상체질의학회지
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• 제26권1호
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• pp.1-10
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• 2014

Objectives This study was aimed to develop the clinical practice guideline for Soeumin symptomatology. This was the first clinical practice guideline, which focuses on symptomatology, not disease. Methods Donguisusebowon and many articles were reviewed and examined for developing clinical practice guidelines. Among the previous guidelines, we assessed the guidelines by Appraisal of Guidelines for Research and Evaluation (AGREE II). After AGREE II assessment, we chose and revised the clinical practice guideline. Results & Conclusions By researching and discussing the Soeumin symptomatology, we make the principle of the clinical practice guideline, including classification, definition, algorithm, and treatment assessing tool.

• 사상체질의학회지
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• 제27권1호
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• pp.1-12
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• 2015

Objectives This study was aimed to develop the clinical practice guideline for Taeeumin, Taeyangin symptomatology. This was the second clinical practice guideline, which focuses on symptomatology. Methods Donguisusebowon and many articles were reviewed and examined for developing clinical practice guidelines. Among the previous guidelines, we assessed the guidelines by Appraisal of Guidelines for Research and Evaluation (AGREE II). After AGREE II assessment, we chose and revised the clinical practice guideline. Results and Conclusions By researching and discussing the Taeeumin, Taeyangin symptomatology, we make the principle of the clinical practice guideline, including classification, definition, algorithm, and treatment assessing tool.