• Journal of Korean Neurosurgical Society
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• v.64 no.3
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• pp.418-426
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• 2021

Objective : A role of diffusion-weighted imaging (DWI) in the diagnosis of cerebral venous thrombosis (CVT) is not well-understood. This study evaluates the effectiveness of DWI in the diagnosis of CVT. Methods : Literature search was conducted in electronic databases for the identification of studies which reported the outcomes of patients subjected to DWI for CVT diagnosis. Random-effects meta-analyses were performed to achieve overall estimates of important diagnostic efficiency indices including hyperintense signal rate, the sensitivity and specificity of DWI in diagnosing CVT, and the apparent diffusion coefficient (ADC) of DWI signal areas and surrounding tissue. Results : Nineteen studies (443 patients with 856 CVTs; age 40 years [95% confidence interval (CI), 33 to 43]; 28% males [95% CI, 18 to 38]; symptom onset to DWI time 4.6 days [95% CI, 2.3 to 6.9]) were included. Hyperintense signals on DWI were detected in 40% (95% CI, 26 to 55) of the cases. The sensitivity of DWI for detecting CVT was 22% (95% CI, 11 to 34) but specificity was 98% (95% CI, 95 to 100). ADC values were quite heterogenous in DWI signal areas. However, generally the ADC values were lower in DWI signal areas than in surrounding normal areas (mean difference-0.33×10-3 ㎟/s [95% CI, -0.44 to -0.23]; p<0.00001). Conclusion : DWI has a low sensitivity in detecting CVT and thus has a high risk of missing many CVT cases. However, because of its high specificity, it may have supporting and exploratory roles in CVT diagnosis.

• Knowledge Management Research
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• v.23 no.2
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• pp.61-82
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• 2022

Metaverse is a combination of Meta and Universe, which refers to a world in which users or avatars engage in social, economic, and cultural activities. This study attempted to compare the four worldviews proposed by the Acceleration Studies Foundation (ASF) based on the five evaluation factors of SPICE, which are factors for promoting customer experience. 227 samples were used in the analysis, and as a result, seamlessness was the highest in augmented reality, interoperability in lifelogging, presence in the mirror world, and concurrence in virtual reality. This study is meaningful in that it presents a model design plan according to the classification of the metaverse platform and the worldview, and presents detailed strategic directions to existing metaverse platform operators or new entrants.

• Journal of Convergence Korean Medicine
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• v.5 no.1
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• pp.5-23
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• 2023

Objectives: This study was conducted to evaluate the effect of combination treatment of herbal medicine for external use and western medicine for atopic dermatitis (AD). Methods: We searched randomized controlled trials (RCTs) which assess the effect of combination treatment of herbal and western medicine for AD through 8 electronic databases from the start to December 2022. The data synthesis was conducted by using Review Manager (RevMan, ver.5.4.1) and Cochrane risk-of-bias tool was used to evaluate the risk of bias. Results: 13 RCTs were included. The combination treatment group had significantly higher total efficacy rate(p<0.0001) and lower SCORAD score (p<0.00001) than the western medicine treatment group. The adverse event rate was also significantly lower in the combination treatment than the western medicine treatment group (p<0.0001). But there was no significant difference in recurrence rate (p=0.09). Conclusion: This study demonstrates that the combination treatment of herbal and western medicine could be safe and effective for AD. However, due to limits of included studies such as high heterogeneity between the literature and unclear risk of bias, further studies are warranted.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.36 no.3
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• pp.74-98
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• 2023

Objectives : This study aims to evaluate the add-on effect of herbal bath combined with acitretin in patients with psoriasis. Methods : We searched randomized controlled trials(RCTs) reporting the effect of herbal bath and acitretin combined treatment for psoriasis in 10 electronic databases from their inception to January 2023. Study collection, data extraction, and risk of bias assessment were performed by two independent researchers. Data synthesis and risk of bias evaluation was conducted using Revman 5.4. Results : Ten RCTs with 1,008 subjects were included. Herbal bath and acitretin combined treatment group showed higher average total effective rate than acitretin alone group(RR 1.39; 95% CI: 1.15-1.68, P=0.0006, I² =0%). Herbal bath and additional treatments such as phototherapy(NB-UVB) and oral herbal medicine, combined with acitretin group also showed higher average total effective rate than acitretin alone group(RR 1.81; 95% CI: 1.47-2.22, P<0.00001, I² =43%). Herbal bath and phototherapy(NB-UVB) combined with acitretin group also showed higher average total effective rate than acitretin alone group(RR 1.51; 95% CI: 1.18-1.93, P=0.0009, I² =0%). The overall risk of bias of the included studies was unclear or of high risks. Conclusions : This review showed that the add-on of herbal bath combined with acitretin treatment could be more effective than acitretin alone treatment in patients with psoriasis. However, because of few included studies, heterogeneity between studies, and insufficient quality of included studies, further well-designed RCTs are needed to confirm the add-on effect of herbal bath on psoriasis.

• Journal of Preventive Medicine and Public Health
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• v.56 no.2
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• pp.128-144
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• 2023

Objectives: The health system reform process is highly political and controversial, and in most cases, it fails to realize its intended goals. This study was conducted to synthesize factors underlying the failure of health system reforms. Methods: In this systematic review and meta-synthesis, we searched 9 international and regional databases to identify qualitative and mixed-methods studies published up to December 2019. Using thematic synthesis, we analyzed the data. We utilized the Standards for Reporting Qualitative Research checklist for quality assessment. Results: After application of the inclusion and exclusion criteria, 40 of 1837 articles were included in the content analysis. The identified factors were organized into 7 main themes and 32 sub-themes. The main themes included: (1) reforms initiators' attitudes and knowledge; (2) weakness of political support; (3) lack of interest group support; (4) insufficient comprehensiveness of the reform; (5) problems related to the implementation of the reform; (6) harmful consequences of reform implementation; and (7) the political, economic, cultural, and social conditions of the society in which the reform takes place. Conclusions: Health system reform is a deep and extensive process, and shortcomings and weaknesses in each step have overcome health reform attempts in many countries. Awareness of these failure factors and appropriate responses to these issues can help policymakers properly plan and implement future reform programs and achieve the ultimate goals of reform: to improve the quantity and quality of health services and the health of society.

• Nutrition Research and Practice
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• v.17 no.2
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• pp.175-191
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• 2023

BACKGROUND/OBJECTIVES: The scientific evidence of a sodium-obesity association is limited by sodium intake assessments. Our specific aim is to synthesize the association between dietary sodium intake and obesity across the sodium intake assessments as evidenced by systematic reviews in adults. SUBJECTS/METHODS: A systematic search identified systematic reviews comparing the association of dietary sodium intakes with obesity-related outcomes such as body mass index (BMI), body weight, waist circumference, and risk of (abdominal) obesity. We searched PubMed on October 24, 2022. To assess the Risk of Bias in Systematic Reviews (ROBIS), we employed the ROBIS tool. RESULTS: This review included 3 systematic reviews, consisting of 39 unique observational studies (35 cross-sectional studies and 4 longitudinal studies) and 15 randomized controlled trials (RCTs). We found consistently positive associations between dietary sodium intake and obesity-related outcomes in cross-sectional studies. Studies that used 24-h urine collection indicated a greater BMI for those with higher sodium intake (mean difference = 2.27 kg/m²; 95% confidence interval [CI], 1.59-2.51; P < 0.001; I² = 77%) compared to studies that used spot urine (mean difference = 1.34 kg/m²; 95% CI, 1.13-1.55; P < 0.001; I² = 95%) and dietary methods (mean difference = 0.85 kg/m²; 95% CI, 0.1-1.51; P < 0.05; I² = 95%). CONCLUSIONS: Quantitative synthesis of the systematic reviews has shown that cross-sectional associations between dietary sodium intake and obesity outcomes were substantially different across the sodium intake assessments. We need more high-quality prospective cohort studies and RCTs using 24-h urine collection to examine the causal effects of sodium intake on obesity.

• Journal of Korean Academy of Nursing
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• v.52 no.1
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• pp.36-51
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• 2022

Purpose: The purpose of this study was to examine the effects of electroencephalogram (EEG) biofeedback training for emotion regulation and brain homeostasis on anxiety about COVID-19 infection, impulsivity, anger rumination, meta-mood, and self-regulation ability of late adolescents in the prolonged COVID-19 pandemic situation. Methods: A non-equivalent control group pretest-posttest design was used. The participants included 55 late adolescents in the experimental and control groups. The variables were evaluated using quantitative EEG at pre-post time points in the experimental group. The experimental groups received 10 sessions using the three-band protocol for five weeks. The collected data were analyzed using the Shapiro-Wilk test, Wilcoxon rank sum test, Wilcoxon signed-rank test, t-test and paired t-test using the SAS 9.3 program. The collected EEG data used a frequency series power spectrum analysis method through fast Fourier transform. Results: Significant differences in emotion regulation between the two groups were observed in the anxiety about COVID-19 infection (W = 585.50, p = .002), mood repair of meta-mood (W = 889.50, p = .024), self-regulation ability (t = - 5.02, p < .001), self-regulation mode (t = - 4.74, p < .001), and volitional inhibition mode (t = - 2.61, p = .012). Neurofeedback training for brain homeostasis was effected on enhanced sensory-motor rhythm (S = 177.00, p < .001) and inhibited theta (S = - 166.00, p < .001). Conclusion: The results demonstrate the potential of EEG biofeedback training as an independent nursing intervention that can markedly improve anxiety, mood-repair, and self-regulation ability for emotional distress during the COVID-19 pandemic.

• Korean Journal of Radiology
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• v.22 no.10
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• pp.1730-1741
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• 2021

Objective: Although thermal ablation is effective in treating low-risk papillary thyroid microcarcinomas (PTMCs), comparison of treatment outcomes between thermal ablation and surgery has not yet been systematically evaluated. This study aimed to compare the efficacy and safety of thermal ablation and surgery for the treatment of low-risk PTMCs. Materials and Methods: Ovid-MEDLINE and EMBASE databases were searched for studies reporting comparisons of treatment results between thermal ablation and surgery for patients with low-risk PTMC published up to April 6, 2020. The analysis evaluated the efficacy (local tumor recurrence, occurrence of new tumor, metastasis, and rescue surgery) and safety (complication rate) of thermal ablation and surgery. Results: This systematic review included four studies with a total of 339 PTMCs in 339 patients who underwent thermal ablation and 320 PTMCs in 314 patients who underwent surgery. There was no local tumor recurrence or distant metastasis in either group. There was no significant difference in the pooled proportion of lymph node metastasis (2.6% with thermal ablation vs. 3.3% with surgery, p = 0.65), occurrence of new tumors (1.4% with thermal ablation vs. 1.3% with surgery, p = 0.85), or rescue surgery (2.6% with thermal ablation vs. 1.6% with surgery, p = 0.62). However, the pooled complication rate was significantly higher in the surgery group than in the ablation group (3.3% with thermal ablation vs. 7.8% with surgery, p = 0.03). Conclusion: Both thermal ablation and surgery are effective and safe options for the management of low-risk PTMCs, with thermal ablation achieving a lower complication rate. Therefore, thermal ablation may be considered as an alternative treatment option for low-risk PTMC in patients who refuse surgery and active surveillance or are ineligible for surgery.

• Korean Journal of Radiology
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• v.20 no.4
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• pp.649-661
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• 2019

Objective: To systematically review the evaluation of the diagnostic accuracy of pre-treatment apparent diffusion coefficient (ADC) and change in ADC during the intra- or post-treatment period, for the prediction of locoregional failure in patients with head and neck squamous cell carcinoma (HNSCC). Materials and Methods: Ovid-MEDLINE and Embase databases were searched up to September 8, 2018, for studies on the use of diffusion-weighted magnetic resonance imaging for the prediction of locoregional treatment response in patients with HNSCC treated with chemoradiation or radiation therapy. Risk of bias was assessed by using the Quality Assessment Tool for Diagnostic Accuracy Studies-2. Results: Twelve studies were included in the systematic review, and diagnostic accuracy assessment was performed using seven studies. High pre-treatment ADC showed inconsistent results with the tendency for locoregional failure, whereas all studies evaluating changes in ADC showed consistent results of a lower rise in ADC in patients with locoregional failure compared to those with locoregional control. The sensitivities and specificities of pre-treatment ADC and change in ADC for predicting locoregional failure were relatively high (range: 50-100% and 79-96%, 75-100% and 69-95%, respectively). Meta-analytic pooling was not performed due to the apparent heterogeneity in these values. Conclusion: High pre-treatment ADC and low rise in early intra-treatment or post-treatment ADC with chemoradiation, could be indicators of locoregional failure in patients with HNSCC. However, as the studies are few, heterogeneous, and at high risk for bias, the sensitivity and specificity of these parameters for predicting the treatment response are yet to be determined.

• Clinical Endoscopy
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• v.56 no.4
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• pp.446-452
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• 2023

Background/Aims: Colonoscopy for screening is associated with unpleasant experiences for patients, and abdominal compression devices have been developed to minimize these problems. However, there is a paucity of data supporting the therapeutic benefits of this strategy. This study examined the effects of using an abdominal compression device during colonoscopy on the cecal intubation time (CIT), abdominal compression, patient comfort, and postural changes. Methods: We searched PubMed and Scopus (from inception to November 2021) for randomized controlled trials that assessed the effects of an abdominal compression device during colonoscopy on CIT, abdominal compression, patient comfort, and postural change. A random-effects meta-analysis was performed. Weighted mean differences (WMDs) and Mantel-Haenszel odds ratios (ORs) were calculated. Results: Our pooled analysis of seven randomized controlled trials revealed that abdominal compression devices significantly reduced CIT (WMD, -0.76 [-1.49 to -0.03] minutes; p=0.04), abdominal compression (OR, 0.52; 95% confidence interval [CI], 0.28-0.94; p=0.03), and postural changes (OR, 0.46; 95% CI, 0.27-0.78; p=0.004) during colonoscopy. However, our results did not show a significant change in patient comfort (WMD, -0.48; 95% CI, -1.05 to 0.08; p=0.09) when using an abdominal compression device. Conclusions: Our findings demonstrate that employing an abdominal compression device may reduce CIT, abdominal compression, and postural change but have no impact on patient comfort.