• The Journal of Internal Korean Medicine
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• v.36 no.3
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• pp.335-347
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• 2015

Objectives This study aims to overview traditional Chinese medicine (TCM) treatment guidelines for severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) in order to facilitate the use of Korean medicine (KM) treatment in pandemic diseases. Methods We compared the characteristics between SARS and MERS, and overviewed the Traditional Chinese Medicine treatment guidelines for SARS and MERS. We assessed the efficacy of simultaneous administration of herbal medicine and Western medicine on SARS by studying Cochranes 2012's Systematic Review Studies. Results and Conclusions Based on wen bing (warm diseases) of KM as well as TCM, KM treatment can be an alternative for pandemic diseases such as SARS and MERS considering the Korean's characteristic environment.

• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.4
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• pp.51-60
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• 2022

Purpose: This study aims to analyze and supplement the standards related to healthcare facilities, negative pressure isolation wards, and emergency treatment facilities. In addition, through environmental investigations, analysis of emergency remodeling cases centered on the structural and HVAC characteristics of healthcare facilities is conducted. Methods: Domestic and foreign standards related to healthcare facilities were analyzed. Field investigations and architectural drawing analysis of general and emergency treatment facilities were conducted. Results: Healthcare facilities have different space classifications and air conditioning methods depending on the site situation. Emergency treatment facilities are classified into cases where the HVAC system is remodeled and portable negative pressure unit is installed, and some facilities did not meet the standards for differential pressure and air change rate. Implications: When developing emergency remodeling technology, remodeling and safety evaluation guidelines, it is considered possible to propose clearer guidelines for emergency remodeling treatment facilities for infectious diseases in Korea by referring to the results of this study.

• Korean Journal of Ecology and Environment
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• v.36 no.3 s.104
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• pp.356-368
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• 2003

Water quality of effluent from wastewater treatment plants (WWTPS) was reviewed to examine the feasibility of agricultural reuse using USEPA and WHO guidelines. It might meet the guidelines for BOD and SS, however, the most critical microbiological concentration was too high and further treatment is required. The pilot study of three treatments were performed to reduce microbiological concentrations. The UV irradiation was proved to be very effective in disinfection of secondary level effluent, and about 30 mW ${\cdot}$ s/$cm^2$ of dose was suggested to meet the even most stringent USEPA guidelines. Slow sand filter demonstrated effective removal of bacteria, and effluent concentration of total coliform (TC), fecal coliform (FC), and E. coli. dropped from about 10,000/100 mL to 300, 200, and 150 MPN/100 mL, respectively, showing over 95% removal. These level of bacterial concentration sufficiently meet the WHO guidelines ($10^3\;{\sim}\;10^5$ FC/100 mL), and could meet the more stringent USEPA guidelines (200 FC/100 mL) if properly applied. Slow sand filter also provided about 50% removal of SS, turbidity, and BOD in addition to bacterial removal. The removal efficiency of pond system was relatively poor, but still showed over 85% removal and effluent concentration of TC, FC, and E. coli was all below 10,000/100 mL. The pond system alone could meet the WHO guidelines, but hardly meet the USEPA guidelines and further treatment might be necessary. Overall, three methods evaluated in the study treat the effluent to meet the WHO microbiological guidelines for agricultural reuse. The UV disinfection and slow sand filter might also could the USEPA guidelines, while the pond system can hardly meet the USEPA guidelines if applied alone. The WHO and USEPA guidelines were made based on data from upland field agricultural system and may not be directly applicable to the paddy field agricultural system. Therefore, national standards for agricultural reuse of reclaimed water should be made considering domestic agricultural systems as well as international guidelines. Also, further investigation is recommended to develop optimum and feasible treatment measures for agricultural reuse of effluent from WWTPs.

• Anxiety and mood
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• v.14 no.2
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• pp.53-62
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• 2018

Objective : The Korean Association of Anxiety Disorders developed Korean guidelines for treatment of panic disorder (PD) 2018. In this paper, we discussed the consensus among psychiatrists, regarding initial and maintenance treatment strategies for pharmacological treatment of PD in Korea. Methods : Based on current treatment guidelines published by the American Psychiatric Association, the National Institute for Clinical Excellence, and the Canadian Psychiatric Association, we developed questionnaires pertinent to initial and maintenance treatment strategies for pharmacological treatment of PD. Seventy-two experts in PD answered questionnaires. We classified expert opinions into three categories, first, second, and third-line treatment strategies, by analyzing the 95% confidence interval. Results : Antidepressants, benzodiazepine anxiolytics, and cognitive-behavioral therapy (CBT) were recommended as treatments of choice (ToC), and first-line strategies for initial treatment of PD. Escitalopram, paroxetine, sertraline, and venlafaxine were preferred from among many anti-panic drugs. Mean starting dose of anti-panic drugs for initial treatment of PD was relatively lower, than that for other psychiatric illnesses such as major depressive disorder. In the case of maintenance treatment of PD, antidepressants and CBT were selected as ToC and first-line strategies. Patients were typically examined every four weeks during treatment, to review effectiveness and side effects of the drug. Pharmacotherapy was generally continued for one year or more. Conclusion : This study provides information about consensus among Korean experts regarding pharmacological treatment strategies for patients with panic disorder.

• Korean Journal of Biological Psychiatry
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• v.13 no.4
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• pp.219-225
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• 2006

Depression has been causing huge direct and indirect losses to people's health because of its high prevalence, various clinical patterns, drug reaction and diverse courses different among individuals, but its treatment has not been systematic but dependent on individual clinicians' experience and knowledge. To correct this problem, it has been highly necessary to develop clinical guidelines defined as "systematically developed statements to assist practitioners' and patients' decisions about appropriate healthcare for specific clinical circumstances." Currently, countries throughout the world are making efforts to establish evidence-based guidelines among different levels of guidelines and to evaluate and test them. Although such efforts have been unsatisfactory in Korea because of several constraints including lack of high-quality RCT, the Korean Depression Clinical Practice Guideline has started to develop evidence-based guidelines, which are established through strictly designed processes. Thus, the present study purposed to review methods adopted in the development processes and to present the processes of developing the evidence-based guidelines clearly and transparently.

• Korean Circulation Journal
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• v.53 no.5
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• pp.294-312
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• 2023

Heart failure (HF) is a global health problem closely related to morbidity and mortality. As the burden of HF increases, it is necessary to manage and treat this condition well. However, there are differences between real-world practice and guidelines for the optimal treatment for HF. Patient-related, healthcare provider-related, and health system-related factors contribute to poor adherence to optimal care. This review article aims to examine HF treatment patterns and treatment adherence in real-world practice, identify clinical gaps to suggest ways to improve the quality of care for HF and clinical outcomes for patients with HF. Although it is important to optimize treatment based on evidence-based guidelines to the greatest extent, it is known that there is still poor treatment adherence, and many patients do not receive guideline-directed medical therapy, especially at the early stages. To improve medication adherence, qualitative evaluation through performance measurement, as well as education of patients, caregivers and medical staff through a multidisciplinary approach are important.

• Tuberculosis and Respiratory Diseases
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• v.79 no.1
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• pp.1-4
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• 2016

Tuberculosis (TB) remains a major public health problem in South Korea. The Joint Committee for the Development of Korean Guidelines for Tuberculosis published the Korean Guidelines for Tuberculosis in 2011 to provide evidence-based practical recommendations to health care workers caring for patients with TB in South Korea. After reviewing recent national and international scientific data on TB, the committee updated the Korean guidelines for TB in 2014. This article presents some practical issues related to the 2014 updated guidelines: namely use of the Mycobacterium tuberculosis-polymerase chain reaction assay and the Xpert MTB/RIF assay in the diagnosis of TB, as well as medical treatment for patients with multidrug-resistant TB.

• Clinical and Experimental Pediatrics
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• v.52 no.8
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• pp.843-850
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• 2009

A recent High Court's decision regarding the withdrawal of life supporting medical treatment (artificial ventilator) from an elderly female patient in the terminal stage has opened up a new era of the "euthanasia dispute" in Korea. With this decision, the legitimate withdrawal of life supporting treatment became possible under certain conditions and the Korean Medical Association is working toward the establishment of practical guidelines for the terminal-stage patients. However, there are still very few debates on the cases of pediatric patients in the terminal stage or suffering from fatal diseases. For pediatric patients, the core principle of autonomy and following procedure of "advance directives" are hardly kept due to the immaturity of the patients themselves. Decisions for their lives usually are in the hands of the parents, which may often bring out tragic disputes around "child abuse", especially in Korea where parents have exclusive control of the destiny of their children. Some developed countries such as the U.S.A., the U.K. and Canada have already established guidelines or a legal framework for ensuring the rights of the healthcare system regarding children suffering from severe illness, permitting the withdrawal of Life supporting medical treatment (LSMT) in very specific conditions when the quality of life of the children is severely threatened. For the protection of the welfare and interest of the children, we should discuss this issue and develop guidelines for the daily practice of pediatricians.

• Archives of Plastic Surgery
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• v.47 no.3
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• pp.263-266
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• 2020

Infantile hemangiomas have a growth phase and an involution phase. For this reason, serial observation has generally been recommended as the treatment for uncomplicated infantile hemangiomas. Recently, however, individualized approaches have been emphasized. Although cleft lip and infantile hemangioma are common congenital diseases, infantile hemangiomas on the cleft side (i.e., in the operative field of the cleft lip) are extremely rare, and no clear guidelines have been established for their treatment. We experienced a case in which a patient with a cleft lip had an infantile hemangioma on the cleft side. In accordance with general treatment guidelines, cleft repair was performed 3 months after birth. The Millard rotation-advancement technique, which involves the use of a lower small triangular flap, was used for the repair. No intraoperative complications, such as massive bleeding, or postoperative complications were noted. The patient has received regular follow-up for the past 18 years, and other than a reddish scar on the lower lip, he currently has no related issues. Therefore, this case demonstrates that cleft lip repair performed according to cleft lip treatment guidelines produces good outcomes, even in cases involving a hemangioma on the cleft side.

• Korean Journal of Clinical Pharmacy
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• v.26 no.1
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• pp.84-95
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• 2016

Objective: Atrial fibrillation (AF) guidelines have been published in the USA and Europe. Recently, the USA and Europe have updated their guidelines, respectively. These new AF guidelines help in addressing key management issues in clinical situations. This study, therefore, systematically compared guidelines for rate and rhythm control pharmacotherapy of patients with AF between the USA (American College of Cardiology and American Heart Association, ACC/AHA) and Europe (European Society of Cardiology, ESC). Methods: This study investigated and compared American guidelines (2014) and European guidelines (2010 and 2012). Results: Generally, there are four meaningful differences between ACC/AHA and ESC guidelines. Important differences are treatment classification system, level of recommendation, drug list, and dosage. In addition, ACC/AHA described pharmacokinetic drug interactions for antiarrhythmic drugs. ESC emphasized ECG and atrioventricular nodal slowing as feature of antiarrhythmic drugs. Conclusion: This research addresses important use of anti-arrhythmic drugs and movement to accept recent recommendations in Korea. For the successful application of the guidelines, a role of pharmacists is crucial in clinical situation.