The reprocessing of gastrointestinal endoscopes and accessories, including pre-cleaning, cleaning, high-level disinfection, rinsing, drying, and storage, is essential for preventing infections during endoscopic procedures. The risk of infection is significantly minimized when these processes are performed properly. However, the reprocessing environment in primary care settings differs from that in endoscopy centers, and ongoing advancements in medical practices and reprocessing technologies highlight the need for updated, context-specific guidelines. The Korean Academy of Family Medicine has developed these guidelines, tailored to the unique conditions of primary care settings, through a comprehensive review of both international and local standards, as well as systematic reviews of relevant literature. This guideline presents step-by-step procedures and key principles for effective endoscope reprocessing, with a focus on the needs of primary care institutions. By adhering to these guidelines, primary care physicians can maintain the highest standards of safety and effectiveness, minimize infection risks, and promote optimal clinical outcomes.

The reprocessing of gastrointestinal endoscopes and accessories, including pre-cleaning, cleaning, high-level disinfection, rinsing, drying, and storage, is essential for preventing infections during endoscopic procedures. The risk of infection is significantly minimized when these processes are performed properly. However, the reprocessing environment in primary care settings differs from that in endoscopy centers, and ongoing advancements in medical practices and reprocessing technologies highlight the need for updated, context-specific guidelines. The Korean Academy of Family Medicine has developed these guidelines, tailored to the unique conditions of primary care settings, through a comprehensive review of both international and local standards, as well as systematic reviews of relevant literature. This guideline presents step-by-step procedures and key principles for effective endoscope reprocessing, with a focus on the needs of primary care institutions. By adhering to these guidelines, primary care physicians can maintain the highest standards of safety and effectiveness, minimize infection risks, and promote optimal clinical outcomes.

The reprocessing of gastrointestinal endoscopes and accessories, including pre-cleaning, cleaning, high-level disinfection, rinsing, drying, and storage, is essential for preventing infections during endoscopic procedures. The risk of infection is significantly minimized when these processes are performed properly. However, the reprocessing environment in primary care settings differs from that in endoscopy centers, and ongoing advancements in medical practices and reprocessing technologies highlight the need for updated, context-specific guidelines. The Korean Academy of Family Medicine has developed these guidelines, tailored to the unique conditions of primary care settings, through a comprehensive review of both international and local standards, as well as systematic reviews of relevant literature. This guideline presents step-by-step procedures and key principles for effective endoscope reprocessing, with a focus on the needs of primary care institutions. By adhering to these guidelines, primary care physicians can maintain the highest standards of safety and effectiveness, minimize infection risks, and promote optimal clinical outcomes.

The reprocessing of gastrointestinal endoscopes and accessories, including pre-cleaning, cleaning, high-level disinfection, rinsing, drying, and storage, is essential for preventing infections during endoscopic procedures. The risk of infection is significantly minimized when these processes are performed properly. However, the reprocessing environment in primary care settings differs from that in endoscopy centers, and ongoing advancements in medical practices and reprocessing technologies highlight the need for updated, context-specific guidelines. The Korean Academy of Family Medicine has developed these guidelines, tailored to the unique conditions of primary care settings, through a comprehensive review of both international and local standards, as well as systematic reviews of relevant literature. This guideline presents step-by-step procedures and key principles for effective endoscope reprocessing, with a focus on the needs of primary care institutions. By adhering to these guidelines, primary care physicians can maintain the highest standards of safety and effectiveness, minimize infection risks, and promote optimal clinical outcomes.

Despite the availability of direct-acting antivirals (DAAs) for chronic hepatitis C virus (HCV) infection in Korea, need remains for pangenotypic regimens that can be used in the presence of hepatic impairment, comorbidities, or prior treatment failure. We investigated the efficacy and safety of sofosbuvir–velpatasvir and sofosbuvir–velpatasvir–voxilaprevir for 12 weeks in HCV-infected Korean adults. Methods: This Phase 3b, multicenter, open-label study included 2 cohorts. In Cohort 1, participants with HCV genotype 1 or 2 and who were treatment-naive or treatment-experienced with interferon-based treatments, received sofosbuvir–velpatasvir 400/100 mg/day. In Cohort 2, HCV genotype 1 infected individuals who previously received an NS5A inhibitor-containing regimen ≥ 4 weeks received sofosbuvir–velpatasvir–voxilaprevir 400/100/100 mg/day. Decompensated cirrhosis was an exclusion criterion. The primary endpoint was SVR12, defined as HCV RNA < 15 IU/mL 12 weeks following treatment. Results: Of 53 participants receiving sofosbuvir–velpatasvir, 52 (98.1%) achieved SVR12. The single participant who did not achieve SVR12 experienced an asymptomatic Grade 3 ASL/ALT elevation on day 15 and discontinued treatment. The event resolved without intervention. All 33 participants (100%) treated with sofosbuvir–velpatasvir–voxilaprevir achieved SVR 12. Overall, sofosbuvir–velpatasvir and sofosbuvir–velpatasvir–voxilaprevir were safe and well tolerated. Three participants (5.6%) in Cohort 1 and 1 participant (3.0%) in Cohort 2 had serious adverse events, but none were considered treatment-related. No deaths or grade 4 laboratory abnormalities were reported. Conclusions: Treatment with sofosbuvir–velpatasvir or sofosbuvir–velpatasvir–voxilaprevir was safe and resulted in high SVR12 rates in Korean HCV patients.

Background/Aims: Glecaprevir/pibrentasvir (G/P) is the first pan-genotypic direct-acting antiviral combination therapy approved in Korea. An integrated analysis of five phase II and III trials was conducted to evaluate the efficacy and safety of G/P in Korean patients with chronic hepatitis C virus (HCV) infection. Methods: The study analyzed pooled data on Korean patients with HCV infection enrolled in the ENDURANCE 1 and 2, SURVEYOR II part 4 and VOYAGE I and II trials, which evaluated the efficacy and safety of 8 or 12 weeks of G/P treatment. The patients were either treatment-naïve or had received sofosbuvir or interferon-based treatment. Efficacy was evaluated by assessing the rate of sustained virologic response at 12 weeks posttreatment (SVR12). Safety was evaluated by monitoring adverse events (AEs) and laboratory assessments. Results: The analysis included 265 patients; 179 (67.5%) were HCV treatment-naïve, and most patients were either subgenotype 1B (48.7%) or 2A (44.5%). In the intention-to-treat population, 262 patients (98.9%) achieved SVR12. Three patients did not achieve SVR12: one had virologic failure and two had non-virologic failures. Most AEs were grade 1/2; eight patients (3.0%) expe-rienced at least one grade ≥3 AE. No serious AEs related to G/P treatment were reported, and grade ≥3 hepatic laboratory abnormalities were rare (0.8%). Conclusions G/P therapy was highly efficacious and well tolerated in Korean patients with HCV infection, with most patients achieving SVR12. The safety profile was comparable to that observed in a pooled analysis of a global pan-genotypic population of patients with HCV infection who received G/P.

Purpose: Acute respiratory distress syndrome (ARDS) is characterized by its acute onset of symptoms such as bilateral pulmonary infiltrates, severe hypoxemia, and pulmonary edema. Many patients with ARDS survive in the acute phase, but then die from significant lung fibrosis. Methods: The effect of combination therapy with polydeoxyribonucleotide (PDRN) and pirfenidone on ARDS was investigated using human lung epithelial A549 cells. ARDS environment was induced by treatment with lipopolysaccharide and transforming growth factor (TGF)-β. Enzyme-linked immunoassay for connective tissue growth factor (CTGF) and hydroxyproline were conducted. Western blot for collagen type I, fibroblast growth factor (FGF), tumor necrosis factor (TNF)-α, and interleukin (IL)-6 was performed. Results: In this study, 8-μg/mL PDRN enhanced cell viability. Combination therapy with PDRN and pirfenidone and pirfenidone monotherapy suppressed expressions of CTGF and hydroxyproline and inhibited expressions of collagen type I and FGF. Combination therapy with PDRN and pirfenidone and PDRN monotherapy suppressed expression of TNF-α and IL-1β. Conclusions The combination therapy with PDRN and pirfenidone exerted stronger therapeutic effect against lipopolysaccharide and TGF-β-induced ARDS environment compared to the PDRN monotherapy or pirfenidone monotherapy. The excellent therapeutic effect of combination therapy with PDRN and pirfenidone on ARDS was shown by promoting the rapid anti-inflammatory effect and inhibiting the fibrotic processes.

PURPOSE: Although it has been suggested that pulmonary tuberculosis (TB) is associated with increased risk of lung cancer, the exact mechanism is not clearly identified. We investigated the effect of pulmonary TB on the epidermal growth factor receptor (EGFR) mutational status and clinical outcome in patients with pulmonary adenocarcinoma. MATERIALS AND METHODS: We reviewed data of patients diagnosed with pulmonary adenocarcinoma harboring EGFR mutations and treated at our institution from 2008 to 2015. We divided our population into two groups: patients with pre-existing TB lesions on chest computed tomography scan (TB group) and those without the lesions (non-TB group). We compared the differences in EGFR mutational status, response to tyrosine kinase inhibitors (TKIs) and survival between the two groups. RESULTS: A total of 477 patients with pulmonary adenocarcinoma were analyzed. One hundred eighty-three patients (39%) had EGFR-mutated tumors and 100 (21%) patients had pre-existing TB lesions. The frequency of EGFR mutation was significantly higher in the TB group compared with the non-TB group (56% vs. 34%, p=0.038). Pre-existing TB lesions were independently associated with more frequent EGFR mutations in multivariate analysis (odds ratio, 1.43). In addition, both the progression-free survival (9.1 months vs. 11.6 months, p=0.020) and the overall survival (19.4 months vs. 24.5 months, p=0.014) after first-line EGFR-TKIs were significantly shorter in the TB group than in the non-TB group. CONCLUSION: Previous pulmonary TB may be associated with more frequent EGFR mutations and poorer treatment response to EGFR-TKIs in patients with pulmonary adenocarcinoma.
Adenocarcinoma* ; Disease-Free Survival ; Humans ; Lung Neoplasms ; Lung* ; Multivariate Analysis ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*

OBJECTIVES: The purpose of this study was to investigate the distinctive features of bodily panic symptoms and the predisposing conditions in Korean patients with panic disorder. METHODS: This was a retrospective chart review study and the data were collected from twelve university-affiliated hospitals in Korea. The patients selected met the diagnostic criteria for panic disorder, were older than 20 years of age, and had initially visited a psychiatry department. The assessments included the chief complaints related to bodily panic symptoms, recent stressors, recent history of alcohol and sleep problems, and time to visit an outpatient clinic. RESULTS: A total of 814 participants were included in the study. The most commonly experienced symptoms were cardiovascular and respiratory symptoms, which were observed in 63.9% and 55.4% of participants, respectively. Just before the onset of a panic attack, 25.6% of participants experienced sleep-related problems. Episodic binge drinking was also frequently observed (13.2%) and was more prevalent in men than in women (22.6% vs. 4.9%, p<0.001). About 75% of participants experienced stressful life events just before panic onset. Work-related issues were more prevalent in men than in women (22.0% vs. 13.4%, p=0.001). Family-related issues (4.8% vs. 14.1%, p<0.001) and conflict with a spouse or partner (4.0% vs.11.7%, p<0.001) were more prominent in women than in men. CONCLUSION Our results suggest that cardiovascular symptoms are the most common bodily panic symptoms in Korean patients. Our results suggest that a substantial portion of the Korean patients experienced stressful life events, sleep problems, and/or episodic binge drinking just before the onset of panic disorder.