• Journal of Yeungnam Medical Science
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• 제40권3호
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• pp.259-267
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• 2023

Background: Malnutrition and impaired immune responses significantly affect the clinical outcomes of patients with atherosclerotic stenosis. The Controlling Nutritional Status (CONUT) score has recently been utilized to evaluate perioperative immunonutritional status. This study aimed to evaluate the relationship between immunonutritional status, indexed by CONUT score, and postoperative complications in patients undergoing carotid endarterectomy (CEA). Methods: We retrospectively evaluated 188 patients who underwent elective CEA between January 2010 and December 2019. The preoperative CONUT score was calculated as the sum of the serum albumin concentration, total cholesterol level, and total lymphocyte count. The primary outcome was postoperative complications within 30 days after CEA, including major adverse cardiovascular events, pulmonary complications, stroke, renal failure, sepsis, wounds, and gastrointestinal complications. Cox proportional hazards regression analysis was used to estimate the factors associated with postoperative complications during the 30-day follow-up period. Results: Twenty-five patients (13.3%) had at least one major complication. The incidence of postoperative complications was identified more frequently in the high CONUT group (12 of 27, 44.4% vs. 13 of 161, 8.1%; p<0.001). Multivariate analyses showed that a high preoperative CONUT score was independently associated with 30-day postoperative complications (hazard ratio, 5.98; 95% confidence interval, 2.56-13.97; p<0.001). Conclusion: Our results showed that the CONUT score, a simple and readily available parameter using only objective laboratory values, is independently associated with early postoperative complications.

• Journal of Acupuncture Research
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• 제40권2호
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• pp.111-128
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• 2023

Trigger finger is a common cause of hand disability that results in finger catching, clicking, or locking. Conventional treatment options such as medication, injection, and surgery have limitations. Studies have indicated that acupuncture and acupotomy can be effective in treating trigger finger. However, no review regarding these treatment modalities has been published yet. This review included randomized controlled trials published until January 2023, investigating acupuncture-related interventions. The primary outcomes of interest included the effectiveness rate (ER) and pain intensity, measured using a visual analog scale (VAS) and Numerical Rating Scale (NRS), and secondary outcomes were the Quinnell grade (QG) and recurrence rate (RR). Adverse events (AEs) have also been reported wherever available. Overall, 19 studies were included, and results demonstrated that arcedge acupuncture improved the ER and QG and reduced NRS, and acupuncture was effective in reducing VAS. Compared with conventional surgery, acupotomy alone improved the ER and QG and lowered VAS and RR, with relatively fewer AEs. Acupotomy add-on treatment was more effective than conventional treatment; however, careful interpretation is needed for VAS. Acupotomy add-on treatment was more effective than acupotomy alone. However, the overall results must be interpreted with caution because of study quality, small sample size, and heterogeneity of the results.

• Journal of Acupuncture Research
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• 제40권3호
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• pp.238-244
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• 2023

Background: Occipital neuralgia (ON) is an established risk factor for headaches in the posterior cervical region. Several conservative treatments by nerve decompression and pain relief are available for ON, but these treatments have limitations. Acupuncture treatment, which is known to demonstrate analgesic effects, involves various stimulation methods, and several studies have reported their clinical benefit. No recent systematic review (SR) has compared each acupuncture type for ON treatment. Thus, this SR aims to investigate the clinical effectiveness of each acupuncture type for treating ON. Methods: We will identify relevant studies using electronic databases, including EMBASE, MEDLINE, Cochrane Library, China National Knowledge Infrastructure (CNKI), Korean Studies Information Service System (KISS), Korean Medical Database, KoreaMed, and National Digital Science Library (NDSL) from the inception until August 2023. The primary outcome will include the numerical change of pain symptoms (visual analog scale and numerical rating scale) and effective rate. Safety and secondary outcomes will include adverse events and quality of life. We will compare the conservative treatment with the acupuncture treatment using network meta-analysis. The Cochrane Collaboration "risk of bias" tools will be used to assess the quality of included trials. The Grades of Recommendation, Assessment, Development, and Evaluation will be used to examine the evidence level. Conclusion: This study will provide clinical evidence of several acupuncture types for ON and help clinicians decide on the best.

• 동의신경정신과학회지
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• 제34권3호
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• pp.163-179
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• 2023

Objectives: The purpose of this study was to provide evidence for the clinical effects of foot bath therapy for insomnia disorder through a systematic review and meta-analysis. Methods: Studies were selected from seven domestic and international literature databases. Data on diagnostic tools, pattern identification, sample size, intervention methods, outcome measurements, results, and adverse events were extracted. The quality of the selected literature was assessed using Cochrane's risk of bias (RoB) assessment tool. Results: A total of 11 studies were included in this study. The primary diagnostic tool for insomnia dis- order was the criteria for the diagnosis and therapeutic effect of diseases and syndromes in traditional Chinese medicine (CDTDSTCM), along with the Chinese classification of mental disorders-3 (CCMD-3). Treatment effects were mainly evaluated by the effective rate and the Pittsburgh Sleep Quality Index (PSQI). The meta-analysis results showed statistically higher effectiveness rates for treating insomnia disorder in the experimental groups receiving herbal medicine foot bath therapy with sleeping or herbal medication compared to the control group. The PSQI was lower in the treatment group receiving herbal medicine foot bath therapy with sleeping medication. The herbal materials used in herbal medicine foot bath therapy mainly included Radix Angelicae Sinensis, Polygonum Multiflorum, Ziziphi Spinosae Semen, Rhizoma Coptidis, Radix Salviae Miltiorrhizae, and Cortex Albizziae. The quality of the included studies was generally poor. Conclusions: This study found that foot bath therapy had clinical efficacy for treating insomnia disorder. The research findings could provide foundational evidence for establishing the clinical basis of foot bath therapy in the treatment of insomnia.

• Journal of Medicine and Life Science
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• 제19권2호
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• pp.46-56
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• 2022

The incidence of fever complicating percutaneous coronary intervention (PCI) is rare. However, little is known regarding the cause of fever after PCI. Therefore, this study aimed to determine the clinical characteristics of patients with acute myocardial infarction (AMI), with or without fever, after PCI. We enrolled a total of 926 AMI patients who underwent PCI. Body temperature (BT) was measured every 4 hours or 8 hours for 5 days after PCI. Patients were divided into two groups according to BT as follows: BT<37.7℃ (no-fever group) and BT ≥37.7℃ (fever group). The 2 years clinical outcomes were compared subsequently. Fever after PCI was associated with higher incidence of major adverse cardiac events (MACE) (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.07-2.28; P=0.021), all-cause death (HR, 2.32; 95% CI, 1.18-4.45; P=0.014), cardiac death (CD) (HR, 2.57; 95% CI, 1.02-6.76; P=0.049), and any revascularization (HR, 1.69; 95% CI, 1.02-2.81; P=0.044) than without fever. In women, prior chronic kidney disease, lower left ventricular (LV) ejection fraction, higher LV wall motion score index, white blood cell count, peak creatine kinase-myocardial band level, and longer PCI duration were associated with fever after PCI. Procedures such as an intra-aortic balloon pump, extracorporeal membrane oxygenation, continuous renal replacement therapy, central and arterial line insertion, and cardiopulmonary resuscitation were related to fever after PCI. Fever after PCI in patients with AMI was associated with a higher incidence of MACE, all-cause death, CD, and any revascularization at the 2 years mark than in those without fever.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권5호
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• pp.249-265
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• 2023

Purpose: Infant regurgitation is associated with other functional gastrointestinal disorders and signs and symptoms that have a major impact on the quality of life of infants and their families. This study evaluated the safety, tolerance, and real-world effectiveness of an anti-regurgitation formula containing locust bean gum (LBG), prebiotics, and postbiotics to alleviate digestive symptoms beyond regurgitation. Methods: This 3-month study involved infants with regurgitation requiring the prescription of an anti-regurgitation formula according to usual clinical practice. Outcomes included evaluation of the evolution of stool consistency and frequency; occurrence of colic, constipation, and diarrhea; and assessment of regurgitation severity. Infant crying, parental assessment of infant well-being, and parental satisfaction with the stool consistency were also evaluated. Results: In total, 190 infants (average age: 1.9±1.1 months) were included. After three months, stool frequency and consistency remained within the normal physiological range, with 82.7% of infants passing one or two stools per day and 90.4% passing loose or formed stools. There was no significant increase in the number of infants with diarrhea, whereas a decrease was observed in the number of infants with constipation after 1 month (p=0.001) and with colic after both 1 and 3 months (p<0.001). Regurgitation severity and crying decreased and parental satisfaction with stool consistency, formula acceptability, infant well-being, and sleep quality increased. Monitoring of adverse events did not reveal any safety concerns. Conclusion: Formulas containing LBG, prebiotics, and postbiotics were well tolerated and provided an effective strategy for managing infant regurgitation and gastrointestinal discomfort.

• 대한한방소아과학회지
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• 제37권3호
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• pp.75-93
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• 2023

Objectives We aimed to analyze the registration status of interventional clinical trials in children and adolescents with chronic cough. Methods All interventional clinical trials registered up to 3 July, 2023 on the international clinical trial registry platform (ICTRP) of the World Health Organization (WHO) were analyzed. Information was extracted including study design, interventions, inclusion and exclusion criteria, and outcome indicators. Results A total of 18 interventional clinical trials were analyzed. For study design, multicentre trials, randomized allocation, parallel group design and phase 4 trials were the most frequently reported. Blinding was used in 44.4% and informed consents were obtained from 61.1%. For intervention, drugs were used in 61.1%, using placebo control group in 27.8%. Quality of life questionnaires were most frequently reported in 50% as the primary outcome, and adverse events were the most as the secondary outcome. In most cases, the assessment timepoints were after two weeks. Conclusions Based on the characteristics of clinical trial design analyzed in this study, it is necessary to design traditional Korean medicine clinical trials with improved quality and accuracy of information.

• 한국임상약학회지
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• 제33권1호
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• pp.1-7
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• 2023

Background: Along with the increase in the elderly population, concerns about polypharmacy, which can cause medication-related problems, are increasing. This study aimed to find out the association between drug-related factors and readmission in elderly patients within 30 days after discharge. Methods: Data of patients aged ≥65 years who were discharged from the respiratory medicine ward of a tertiary hospital between January and March 2016 were retrospectively obtained. The medication regimen complexity at discharge was calculated using the medication regimen complexity index (MRCI) score, comorbidity status was assessed using the Charlson comorbidity index (CCI), potentially inappropriate medications (PIMs) were evaluated based on the Beer 2019 criteria, and adverse drug events (ADEs) were examined using the ADE reporting system. Multivariable logistic regression analysis was used to evaluate the effect of medication-related problems on hospital readmission after controlling for other variables. Results: Of the 206 patients included, 84 (40.8%) used PIMs, 31 (15%) had ADEs, and 32 (15.5%) were readmitted. The mean age, total medications, MRCI, CCI, and PIMs in the readmission group were significantly higher than those in the non-readmission group. Age significantly decreased the risk of readmission (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.84-0.96) after adjusting for sex, length of hospital stay, and ADEs. The use of PIMs (OR, 2.38; 95% CI, 1.10-5.16) and increased CCI (OR, 1.50; 95% CI, 1.16-1.93) and MRCI (OR, 1.04; 95% CI, 1.01-1.07) were associated with an increased occurrence of readmission. Conclusion: PIMs were associated with a significantly greater risk for readmission than MRCI.

• Archives of Plastic Surgery
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• 제50권1호
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• pp.30-36
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• 2023

Background Most children with facial lacerations require sedation for primary sutures. However, sedation guidelines for invasive treatment are lacking. This study evaluated the current status of the sedation methods used for pediatric facial laceration repair in Korea. Methods We surveyed one resident in each included plastic surgery training hospital using face-to-face interviews or e-mail correspondence. The health care center types (secondary or tertiary hospitals), sedation drug types, usage, and dosage, procedure sequence, monitoring methods, drug effects, adverse events, and operator and guardian satisfaction were investigated. Results We included 45/67 hospitals (67%) that used a single drug, ketamine in 31 hospitals and chloral hydrate in 14 hospitals. All health care center used similar sedatives. The most used drug administered was 5 mg/kg intramuscular ketamine (10 hospitals; 32%). The most common chloral hydrate administration approach was oral 50 mg/kg (seven hospitals; 50%). Twenty-two hospitals (71%) using ketamine followed this sequence: administration of sedatives, local anesthesia, primary repair, and imaging work-up. The most common sequence used for chloral hydrate (eight hospitals; 57%) was local anesthesia, administration of sedatives, imaging work-up, and primary repair. All hospitals that used ketamine and seven (50%) of those using chloral hydrate monitored oxygen saturation. Median operator satisfaction differed significantly between ketamine and chloral hydrate (4.0 [interquartile range, 4.0-4.0] vs. 3.0 [interquartile range, 3.0-4.0]; p <0.001). Conclusion The hospitals used various procedural sedation methods for children with facial lacerations. Guidelines that consider the patient's condition and drug characteristics are needed for safe and effective sedation.

• Journal of Periodontal and Implant Science
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• 제53권2호
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• pp.145-156
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• 2023

Purpose: The significance of keratinized tissue for peri-implant health has been emphasized. However, there is an absence of clinical evidence for the use of a xenogeneic collagen matrix (XCM) to manage peri-implant mucositis and peri-implantitis. Therefore, the purpose of this study was to investigate outcomes after keratinized tissue augmentation using an XCM for the management of peri-implant diseases. Methods: Twelve implants (5 with peri-implant mucositis and 7 with peri-implantitis) in 10 patients were included in this study. Non-surgical treatments were first performed, but inflammation persisted in all implant sites. The implant sites all showed a lack of keratinized mucosa (KM) and vestibular depth (VD). Apically positioned flaps with XCM application were performed. Bone augmentation was simultaneously performed on peri-implantitis sites with an intrabony defect (>3 mm). The following clinical parameters were measured: the probing pocket depth (PPD), modified sulcular bleeding index (mSBI), suppuration (SUP), keratinized mucosal height (KMH), and VD. Results: There were no adverse healing events during the follow-up visits (18±4.6 months). The final KMHs and VDs were 4.34±0.86 mm and 8.0±4.05 mm, respectively, for the sites with peri-implant mucositis and 3.29±0.86 mm and 6.5±1.91 mm, respectively, for the sites with peri-implantitis. Additionally, the PPD and mSBI significantly decreased, and none of the implants presented with SUP. Conclusions: Keratinized tissue augmentation using an XCM for sites with peri-implant mucositis and peri-implantitis was effective for increasing the KMH and VD and decreasing peri-implant inflammation.