• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.28 no.2
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• pp.70-83
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• 2017

The objective of this review is the revision of the Korean practice parameters for the pharmacological treatment of attention-deficit hyperactivity disorder (ADHD) based on the change in the diagnostic system from DSM-IV-TR to DSM-5 and psychopharmacological developments. For the evidence-based approach, the authors conducted a review of the literature, including controlled clinical trials, studies of the side effects of drugs, toxicology and meta-analyses from the United States and Europe, as well as recent research conducted in Korea. The review committee composed of Korean experts on ADHD reviewed the revised parameters. This revised version reveals how to use central nervous system psychostimulants, non-stimulants such as atomoxetine and alpha2 agonists, and other medication for ADHD, and how to manage the adverse effects of such medication. At the end of this revised version, the authors propose recommendations for the pharmacotherapy of ADHD.

• Tuberculosis and Respiratory Diseases
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• v.83 no.1
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• pp.20-30
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• 2020

Tuberculosis (TB) remains a threat to public health and is the leading cause of death globally. Isoniazid (INH) is an important first-line agent for the treatment of TB considering its early bactericidal activity. Resistance to INH is now the most common type of resistance. Resistance to INH reduces the probability of treatment success and increases the risk of acquiring resistance to other first-line drugs such as rifampicin (RIF), thereby increasing the risk of multidrug-resistant-TB. Studies in the 1970s and 1980s showed high success rates for INH-resistant TB cases receiving regimens comprised of first-line drugs. However, recent data have indicated that INH-resistant TB patients treated with only firs-tline drugs have poor outcomes. Fortunately, based on recent systematic meta-analyses, the World Health Organization published consolidated guidelines on drug-resistant TB in 2019. Their key recommendations are treatment with RIF-ethambutol (EMB)-pyrazinamide (PZA)-levofloxacin (LFX) for 6 months and no addition of injectable agents to the treatment regimen. The guidelines also emphasize the importance of excluding resistance to RIF before starting RIF-EMB-PZA-LFX regimen. Additionally, when the diagnosis of INH-resistant TB is confirmed long after starting the first-line TB treatment, the clinician must decide whether to start a 6-month course of RIF-EMB-PZA-LFX based on the patient's condition. However, these recommendations are based on observational studies, not randomized controlled trials, and are thus conditional and based on low certainty of the effect estimates. Therefore, further work is needed to optimize the treatment of INH-resistant TB.

• Korea Journal of Hospital Management
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• v.21 no.1
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• pp.14-31
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• 2016

Obesity of adolescents causes mental and physical problems as well as social problems, which need prevention and management. Although a number of systematic reviews and meta-analyses on obesity programs for adolescents were conducted, there is no study evaluating the programs based on CCM(Chronic Care Model), an organizing framework for improving chronic illness care. This study was conducted to review the features of studies in obesity management programs and interventions of the selected studies were evaluated in terms of inclusion of components of the Chronic Care Model. 4 databases were searched for relevant studies in obesity management programs, which were published from 1994 to 2014 in Korea. Results were analyzed in a qualitative way. 14 studies were satisfied inclusion criteria. The interventions most frequently utilized the elements of self-management support(66.7%) and only 1 of the studies included more than three components of CCM. This study presents the direction of health policies about managements of metabolic syndrome, which means that we identified effective process of the obesity management programs for adolescents in Korea and also this study will be used as a basic information for the development of obesity management program.

• Applied Biological Chemistry
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• v.42 no.3
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• pp.252-255
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• 1999

Inhibition activities$(pI_{50})$ of chalcone derivatives as substrate with farnesyl protein transferase(FPTase) were determined in vitro. The structure activity relationships(SAR) between the activity and physicochemical parameters of X & Y-substituents on the phenyl groups were analyzed by Free-Wilson and Hansch method. X-substituents on the benzoyl group have the more important role to inhibition activity than Y-substituents on the styryl group. Among them, none substituent, 8 showed the highest FPTase inhibition activity$(pI_{50}=4.30)$. Particularly, the SAR equation could be formulated, showing a parabolic relationship between the activity and hydrophobicity(logP) where the optimal value$({\Sigma}logP)_{opt}$ was 3.915. And also the activity depends on the steric effect(Es > 0) with X-substituent and the resonance effect(R < 0) with electron donating Y-substituents. Based on the results of SAR analyses, the interactions between substrates and receptor, FPTase, could be assumed.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6643-6647
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• 2014

The breast and the thyroid are hormone responsive organs that are closely related with changes of endocrine function and glandular disease. An association between thyroid disorders and breast cancer (BC) risk has been suggested, although the results are inconclusive. The purpose of the present study was to summarize evidence supporting a relationship between BC and the level of thyroid hormones and antibodies. The MEDLINE and EMBASE electronic databases were searched for studies published between 2000 and 2014. The pooled effects were presented as weighted mean differences (WMD) with 95% confidence intervals (CI) using fixed or random effect models. We summarized the results of 8 cross-sectional studies with 4, 189 participants. The overall pooled results showed that the levels of $FT_3$ and $FT_4$ were significantly increased in patients with BC (WMD=1.592 pmol/l; 95% CI: 0.15-3.033 and WMD=0.461 ng/dl; 95% CI: 0.015-0.906; p=0.043). The TPOAb level in patients with BC was higher than that in the control group (WMD=81.4 IU/ml; 95% CI: 78.7-84.0; p=0.000). The overall pooled results of the TgAb with random effects analyses showed that the TgAb level was significantly increased in patients with BC (WMD=101.3 IU/ml; 95% CI: 48.7-153.9; p=0.000). The present results indicated that the serum levels of $FT_3$, TPOAb and TgAb are significantly higher in patients with breast cancer than in healthy controls.

• Nutrition Research and Practice
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• v.5 no.5
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• pp.450-454
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• 2011

The beneficial effects of total parenteral nutrition (TPN) in improving the nutritional status of malnourished patients during hospital stays have been well established. However, recent randomized trials and meta-analyses have reported an increased rate of TPN-associated complications and mortality in critically ill patients. The increased risk of complications during TPN therapy has been linked to the development of hyperglycemia, especially during the first few days of TPN therapy. This retrospective study was conducted to determine whether the amount of dextrose from TPN in the 1st week in the intensive care unit (ICU) was related to the development of hyperglycemia and the clinical outcome. We included 88 non-diabetic critically ill patients who stayed in the medical ICU for more than two days. The subjects were 65 ${\pm}$ 16 years old, and the mean APACHE (Acute Physiology and Chronic Health Evaluation) II score upon admission was 20.9${\pm}$7.1. The subjects received 2.3${\pm}$1.4 g/kg/day of dextrose intravenously. We divided the subjects into two groups according to the mean blood glucose (BG) level during the 1st week of ICU stay: <140 mg/dl vs ${\geq}$ 140 mg/dl. Baseline BG and the amount of dextrose delivered via TPN were significantly higher in the hyperglycemia group than those in the normoglycemia group. Mortality was higher in the hyperglycemia group than in the normoglycemia group (42.4% vs 12.8%, P=0.008). The amount of dextrose from TPN was the only significant variable in the multiple linear regression analysis, which included age, APACHE II score, baseline blood glucose concentration and dextrose delivery via TPN as independent variables. We concluded that the amount of dextrose delivered via TPN might be associated with the development of hyperglycemia in critically ill patients without a history of diabetes mellitus. The amount of dextrose in TPN should be decided and adapted carefully to maintain blood glucose within the target range.

• Informatization Policy
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• v.20 no.4
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• pp.3-22
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• 2013

This study analyzed the research trends and methodologies through meta analysis method on the issues of ICT policy and e-government in Korean major journals and proceedings including Korean Association of Public Administration (KAPA), Korean Association of Policy Studies (KAPS), and Korean Journal of Information Policy of NIA (National Information Agency). The results showed that methodology has changed from explorative study with conceptualization to experimental study with theoretical model and cases. Qualitative approaches including case studies and description with policy implications were employed more as analyses tools. In terms of contents, system effectiveness and e-governance issues prevailed in the early 2000s, and since then, it has changed into ICT-based social changes and looking for generalization of theories including e-democracy, e-service, e-participation, digital divide, and post-information society. Now we are facing another ICT revolution of social network via web3.0 and gov3.0 and it is time to open a new theoretical debate, deconstruction of discourse, and collaborative perspective among different disciplines.

• Korean Journal of Adult Nursing
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• v.16 no.3
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• pp.409-420
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• 2004

Purpose: This study aims to analyze the effectiveness of Tai chi exercise for improving balance and its tendency and helps to identify directions for future research. Method: 19 articles from Medline search of foreign journals(1981-2003) and 5 from Korean nursing journals (1981-2003) were surveyed. The contents analyses were focused on outcome measures and relative factors regarding balance. Result: Variable measures for balance were used in Tai Chi studies relating to balance. They included the functional measures such as 14 single-leg stance, 7 walking in physiological measures and 7 laboratory-based balance measures were done with platform stability test. The measure of effective Tai Chi exercise depended on the health status of subjects and the methods. Health status of subjects were only on physically inactive older adults in 17 articles and arthritis patients in 7 articles in the Tai Chi study. The significant effects of Tai Chi exercise on balance was revealed after 10weeks duration. Conclusion: Considering the results, Tai Chi exercise is more effective than any other studies for walking balance. But the reports on the outcome are inconsistent with wide variations in the choice of balance measures. It is suggested that future studies analyze systemic change through meta analysis and have a wide variety of subjects who need postural control and balance control. The methods of measures should be distinct from the balance state of subjects for the effectiveness of Tai chi exercise.

• Journal of Preventive Medicine and Public Health
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• v.50 no.2
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• pp.68-82
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• 2017

Objectives: We performed a systematic review to assess and aggregate the available evidence on the frequency, expected effects, obstacles, and facilitators of disclosure of patient safety incidents (DPSI). Methods: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for this systematic review and searched PubMed, Scopus, and the Cochrane Library for English articles published between 1990 and 2014. Two authors independently conducted the title screening and abstract review. Ninety-nine articles were selected for full-text reviews. One author extracted the data and another verified them. Results: There was considerable variation in the reported frequency of DPSI among medical professionals. The main expected effects of DPSI were decreased intention of the general public to file medical lawsuits and punish medical professionals, increased credibility of medical professionals, increased intention of patients to revisit and recommend physicians or hospitals, higher ratings of quality of care, and alleviation of feelings of guilt among medical professionals. The obstacles to DPSI were fear of medical lawsuits and punishment, fear of a damaged professional reputation among colleagues and patients, diminished patient trust, the complexity of the situation, and the absence of a patient safety culture. However, the factors facilitating DPSI included the creation of a safe environment for reporting patient safety incidents, as well as guidelines and education for DPSI. Conclusions: The reported frequency of the experience of the general public with DPSI was somewhat lower than the reported frequency of DPSI among medical professionals. Although we identified various expected effects of DPSI, more empirical evidence from real cases is required.

• Archives of Plastic Surgery
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• v.40 no.2
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• pp.91-96
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• 2013

Background A thinned anterolateral thigh (ALT) flap is often harvested to achieve optimal skin resurfacing. Several techniques have been described to thin an ALT flap including an adipocutaneous flap, an adipofascial flap and delayed debulking. Methods By systematically reviewing all of the available literature in English and French, the present manuscript attempts to identify the common surgical indications, complications and donor site morbidity of the adipofascial variant of the ALT flap. The studies were identified by performing a systematic search on Medline, Ovid, EMBASE, the Cochrane Database of Systematic Reviews, Current Contents, PubMed, Google, and Google Scholar. Results The study selection process was adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and 15 articles were identified using the study inclusion criteria. These articles were then reviewed for author name(s), year of publication, flap dimensions and thickness following defatting, perforator type, type of transfer, complications, thinning technique, number of cases with a particular area of application and donor site morbidity. Conclusions The adipofascial variant of the ALT flap provides tissue to fill large defects and improve pliability. Its strong and safe blood supply permits adequate immediate or delayed debulking without vascular complications. The presence of the deep fascia makes it possible to prevent sagging by suspending and fixing the flap for functional reconstructive purposes (e.g., the intraoral cavity). Donor site morbidity is minimal, and thigh deformities can be reduced through immediate direct closure or liposuction and direct closure. A safe blood supply was confirmed by the rate of secondary flap debulking.