• Journal of Gastric Cancer
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• 제20권4호
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• pp.345-354
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• 2020

Early detection of gastric cancer is crucial because the survival rate can be improved through curative treatment. Although surgery and gastrectomy with lymph node dissection remain as the gold standard for curative treatment, early gastric cancer (EGC) with negligible risk of lymph node metastasis can be treated with endoscopic resection (ER), such as endoscopic submucosal dissection. Among gastric cancers, undifferentiated-type cancer is distinguished from differentiated-type cancer in various aspects in terms of clinical features and pathophysiology. The undifferentiated-type cancer is also known to be associated with an aggressive behavior and a poor prognosis. Therefore, the indication of ER for undifferentiated EGC is limited compared with differentiated-type. Recent studies have reported that ER for undifferentiated EGC is safe and shows favorable short- and long-term outcomes. However, it is necessary to understand the details of the research results and to selectively accept them. In this review, we aimed to evaluate the current practice guidelines and the short-term and long-term outcomes of ER for undifferentiated type EGC.

• 신경정신의학
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• 제57권4호
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• pp.287-300
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• 2018

Of the different phases of bipolar disorder, bipolar depression is more prevailing and is more difficult to treat. However, there is a deficit in systemic research on the pharmacological treatment of acute bipolar depression. Therefore, consensuses on the pharmacological treatment strategies of acute bipolar depression has yet to be made. Currently, there are only three drugs approved by the Food and Drug Administration for acute bipolar depression : quetiapine, olanzapine-fluoxetine complex, and lurasidone. In clinical practice, other drugs such as mood stabilizers (lamotrigine, lithium, valproate) and/or the other atypical antipsychotics (aripiprazole, risperidone, ziprasidone) are frequently prescribed. There remains controversy on the use of antidepressants in bipolar depression. Here, we summarized the evidence of current pharmacological treatment options and reviewed treatment guidelines of acute bipolar depression from recently published studies.

• Korean Journal of Radiology
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• 제25권2호
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• pp.134-145
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• 2024

Abnormalities on breast ultrasound (US) images which do not meet the criteria for masses are referred to as nonmass lesions. These features and outcomes have been investigated in several studies conducted by Asian researchers. However, the term "nonmass" is not included in the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) 5th edition for US. According to the Japan Association of Breast and Thyroid Sonology guidelines, breast lesions are divided into mass and nonmass. US findings of nonmass abnormalities are classified into five subtypes: abnormalities of the ducts, hypoechoic areas in the mammary glands, architectural distortion, multiple small cysts, and echogenic foci without a hypoechoic area. These findings can be benign or malignant; however, focal or segmental distributions and presence of calcifications suggest malignancy. Intraductal, invasive ductal, and lobular carcinomas can present as nonmass abnormalities. For the nonmass concept to be included in the next BI-RADS and be widely accepted in clinical practice, standardized terminologies, an interpretation algorithm, and outcome-based evidence are required for both screening and diagnostic US.

• The Korean Journal of Medicine
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• 제99권3호
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• pp.127-133
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• 2024

Subclinical hypothyroidism (SCH) is characterized by elevated serum thyroid-stimulating hormone (TSH) levels and normal free thyroxine levels. The Korean Thyroid Association recently issued guidelines for managing SCH. Based on the Korea National Health and Nutrition Examination Survey (2013-2015), a serum TSH level of 6.8 mIU/L is the reference value for SCH. SCH is classified as mild (TSH 6.8-10.0 mIU/L) or severe (TSH > 10.0 mIU/L), and patients are categorized as adult (age < 70 years) or elderly (age ≥ 70 years). Levothyroxine treatment (LT4-Tx) is not recommended for mild or even severe SCH in elderly patients. Immediate LT4-Tx can be given to adults in most cases, but not to women who are pregnant, patients with progressive disease, or patients with underlying coronary artery disease, heart failure, or dyslipidemia.

• 간호행정학회지
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• 제20권1호
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• pp.128-143
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• 2014

Purpose: Effective literature searching is essential to support evidence-based nursing. The aim of this study was to present our recent systematic search experience to identify guidelines in PubMed for prevention of catheter-associated urinary tract infections. Methods: Five approaches to the literature search via PubMed were employed. The searches were restricted to items published from 1980 to 2010, for patients admitted to hospital, and in the English language. The search results were compared using the number of records and relevant items, and the sensitivity and precision of each search strategy. Results: The individual approaches retrieved 19-141 of records and 3-6 of relevant items. Sensitivity ranged from 37.5% to 75.0% with the highest values for simple searches and a search combining MeSH terms and free textwords with a methodological search filter. Precision varied from 4.3% to 21.7% and the highest precision was found for MeSH terms with limits feature. Conclusion: The simple search in PubMed is an appropriate way for nurses in a busy clinical practice to search the literature for evidence. However, several approaches using MeSH terms, free textwords, limits feature or methodological search filters are also required to have more efficient and better informed search results.

• Nutrition Research and Practice
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• 제5권6호
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• pp.560-568
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• 2011

Consumption of a diet consistent with dietary guidelines is believed to have a beneficial effect on the prevention of chronic diseases and the promotion of general health. This study was conducted to explore the relationship between adherence to the Korean Food Guidance System (KFGS), which was based on the 2010 revised KDRIs, and the risk of metabolic abnormalities. Five hundred and ninety-six Korean adults between 30 and 59 years of age were recruited by advertisement to the Bundang Jesaeng General Hospital (BJGH), and those not taking regular medications and without diagnoses of fulminant disease were included. Data were collected on anthropometric measurements, diagnostic parameters for metabolic syndrome (MetS), and 3-day dietary intakes from individuals in the study. The number of servings consumed from each food group was compared to the KFGS recommended servings for each of the 6 food groups. Poor adherence to the recommendations for servings of milk and dairy products (OR: 2.038, 1.128-3.682) was associated with a higher risk of MetS, and poor adherence to the guidelines for fruit consumption (OR: 1.849, 1.027-3.329) was associated with a higher risk for the existence an elevated waist circumference. Conversely, the consumption of meat, fish, eggs, and beans above the recommended number of servings was associated with a lower risk of having an elevated waist circumference (OR: 0.523, 0.288-0.950), and the consumption of vegetables above the recommended number of servings was associated with a reduced risk of having elevated fasting glucose (OR: 0.533, 0.298-0.954). These results suggest that adherence to the KFGS guidelines helps to prevent the development of MetS, but this association needs to be confirmed by prospective studies.

• Nutrition Research and Practice
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• 제7권1호
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• pp.49-58
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• 2013

The most critical point in the assessment of adherence to dietary guidelines is the development of a practical definition for adherence, such as a dietary pattern score. The purpose of this study was to develop the Korean Diet Score (KDS) based on the Korean Food Balance Wheel and to examine the association of KDS with various lifestyle characteristics and biochemical factors. The dietary data of 5,320 subjects from the 4th Korean National Health and Nutritional Examination Survey were used for the final analysis. The food guide was composed of six food group categories; 'grain dishes', 'fish and meat dishes', 'vegetable dishes', 'fruits', 'milk' and 'oils and sugars'. Based on the recommended serving numbers for each group, the scores measuring adherence to this food guide were calculated from the dietary information from the 24-hour dietary recall questionnaire, and then its correlation with various characteristics was assessed. KDS was significantly associated with several clinical, lifestyle and socioeconomic factors as well as diagnosed disease history. The higher quintile group of KDS showed a significantly lower level in fasting blood glucose, systolic blood pressure, triglycerides, current smoking and drinking as well as higher leisure time activity, house income and education. Furthermore, the KDS quintile group of women was inversely associated with hypertension, osteoporosis and diabetes. A higher KDS quintile was characterized with a higher intake of several critical nutrients, such as Ca, Fe and vitamins as well as a desirable nutrition balance such as the ratio of macronutrients. Our results demonstrate that KDS is a beneficial tool in assessing the adherence to a healthy diet based on the Korean dietary guidelines. We suggest that KDS could be a useful indicator for evaluating the dietary balance of the Korean population.

• Journal of Pharmaceutical Investigation
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• 제37권2호
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• pp.119-126
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• 2007

Tablet splitting is used in pharmacy practice to adjust the dose to be administered. However, it also causes several problems such as undesirable effect for sustained release or enteric-coated dosage form, inaccuracy of dose, and pharmacist's safety by splitting hazardous drugs. This study investigated the current status of oral dosage form splitting for patients older than 19 years by analyzing Korea National Health Insurance Claims Database. Out of oral solid drugs prescribed (N=1,486,584) 9.8% of them included tablets (or capsules) split. There were some splitting cases even in sustained release (4.9%), enteric-coated forms (1.3%) and hazardous drugs (2.7%) that were selected by NIOSH (The National Institute for Occupational Safety and Health). The most frequently split drugs were antihistamines, neuropsychotics and steroids. In case of digoxin and warfarin, unit doses in a domestic market were not diverse compared to foreign markets. Guidelines for splitting oral solid dosage forms, approval of diverse doses and conducting dose-response studies for the commonly splitting ingredients on Korean people are needed for the saff and effective use of oral solid drugs.

• 한방안이비인후피부과학회지
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• 제28권1호
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• pp.119-133
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• 2015

Objective : Thread embedding acupuncture has become popular as a minimally invasive treatment for facial wrinkles and laxity. However, there is little published clinical practice guidelines. This study is to developing a specific procedure of thread embedding acupuncture for facial wrinkles and laxity. Method : We reviewed and summarized 6 studies on thread embedding acupuncture for facial wrinkles and laxity. And, four practitioners who have more than four year of clinical experience and one hundred of cases were participated in developing a thread embedding acupuncture procedure for facial wrinkles and laxity. Result and conclusion : We developed a thread embedding acupuncture procedure for facial wrinkles and laxity which consists of correction of lower jaw, facial laxity, nasolabial fold and eye wrinkles.

• 기본간호학회지
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• 제20권4호
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• pp.345-358
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• 2013

Purpose: The purpose of this study was to develop a protocol that would help prevent accidents, apply physical restraints properly, and reduce the use of physical restraints in nursing homes. Method: A review of the literature and analysis of existing statutes and regulations were used to develop the preliminary protocol. To test the validity of this preliminary protocol, ten experts were selected from academia and clinical practice to review the protocol. The initial protocol was finalized after it had been reviewed by experts and tested for clinical validity in five different nursing homes. Result: The protocol consists of objectives, definitions and accident probability assessment, principle of using physical restraints, monitoring and documentation of physical restraints. Conclusion: The findings of this study can be used as guidelines to focus on preventing accidents arising out of use of physical restraints, assessing the probability of accidents, and reducing the use of physical restraints through preventive interventions. This will be helpful to prevent ethical, physical, or psychological problems arising from use of physical restraints and to protect the rights of elderly people in nursing homes.