• 한국임상약학회지
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• 제32권4호
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• pp.336-351
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• 2022

Background: Prader-Willi Syndrome (PWS) is a rare genetic disorder. To improve the health deterioration of PWS, investigating optimal treatment options for PWS is required. Thus, we aimed to evaluate the efficacy of pharmacotherapies compared with supportive care or placebos in patients with PWS. Methods: PubMed and EMBASE databases were used to search for randomized controlled trials (RCTs) evaluating the efficacy of pharmacotherapy in PWS patients. Only RCTs that evaluating the efficacy of pharmacotherapy in PWS patients were retrieved. Results: A total of 26 studies were included to evaluate body composition, hormones, glucose levels and hyperphagia behavioral status. Pharmacological treatment group showed a significant decrease of body fat (mean difference (MD): -6.32, 95% confidence interval (CI): -10.58 to -2.06, p=0.004), a significant increase of lean body mass (LBM) (MD: 1.86, 95% CI: 1.43 to 2.30, p<0.00001) and insulin-like growth factor 1 (IGF-1) levels (MD: 241.62, 95% CI: 68.59 to 414.64, p=0.006) compared with the control group. Nevertheless, based on other outcomes evaluated by the current systematic review, pharmacological options showed different efficacy in treating PWS. Conclusion: Pharmacological therapies were effective to decrease significantly in body fat and increase significantly on LBM and IGF-1 levels in patients with PWS. However, still, individualized therapies should be considered in real-world practice in PWS treatment.

• Childhood Kidney Diseases
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• 제28권1호
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• pp.8-15
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• 2024

With the rapid evolution of diagnostic tools, particularly next-generation sequencing, the identification of genetic diseases, predominantly those with pediatric-onset, has significantly advanced. However, this progress presents challenges that span from selecting appropriate tests to the final interpretation of results. This review examines various genetic testing methodologies, each with specific indications and characteristics, emphasizing the importance of selecting the appropriate genetic test in clinical practice, taking into account factors like detection range, cost, turnaround time, and specificity of the clinical diagnosis. Interpretation of variants has become more challenging, often requiring further validation and significant resource allocation. Laboratories primarily classify variants based on the American College of Medical Genetics and Genomics and the Association for Clinical Genomic Science guidelines, however, this process has limitations. This review underscores the critical role of clinicians in matching patient phenotypes with reported genes/variants and considering additional factors such as variable expressivity, disease pleiotropy, and incomplete penetrance. These considerations should be aligned with specific gene-disease characteristics and segregation results based on an extended pedigree. In conclusion, this review aims to enhance understanding of the complexities of clinical genetic testing, advocating for a multidisciplinary approach to ensure accurate diagnosis and effective management of rare genetic diseases.

• 임상간호연구
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• 제25권3호
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• pp.221-236
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• 2019

Purpose: The purpose of this study was to systematically review and identify factors relevant to the positive psychological capital of clinical nurses. Methods: These was no limit on year of publication. Articles related to Korean clinical nurses were retrieved from computerized database using a manual search. A systematic review was conducted based on the PRISMA flow. The total correlational effect size (ESr) for each related factor was calculated from Fisher's Zr. Funnel plots, fail-safe numbers, and Egger regression tests were used to evaluate publication bias in meta-analysis studies. The correlational effect size of 25 studies was analyzed through meta-analysis using Comprehensive Meta-Analysis software 3.0 (CMA). Results: The review included 25 studies. In the systematic review, 14 demographic factors and 46 organizational factors were found to be influential. Eleven factors (6 demographic factors and 5 organizational factors) were appropriate for meta-analysis. The overall effect size was .26. The demographic total correlation effect size of related factors was .20 and the total effect size of organization was .46. Organizational commitment (ESr=.38) and job satisfaction (ESr=.54) were statistically positively related variables. Negative variables were burnout (ESr=-.61), turnover intention (ESr=-.41) and workplace bullying (ESr=-.33). The total effect size of the organizational factors was larger than the demographic total effect size. There was no publication bias except for demographic variables. Conclusion: Organizational factors and adjustable variables have a significant impact on positive psychological capital. The results of this study support the need for development of interventions focusing on organizational factors.

• 한방재활의학과학회지
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• 제32권2호
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• pp.83-94
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• 2022

Objectives This systematic review aimed to analyze research about pelvic deviation diagnosis for Chuna manual therapy (CMT) and to review the diagnosis methods, indices, and results of diagnosis. Methods Ten electronic databases were systematically searched up to January 4th 2022. Clinical studies and reviews containing pelvic deviation diagnosis for CMT or using CMT as a treatment of pelvic deviation were selected and evaluated. CMT diagnosis in clinical studies and reviews were isolated and analyzed by 2 independent reviewers. Results Thirteen clinical studies and three reviews were included in the evaluation. X-ray analysis and manual testing were the two main methods used in CMT diagnosis of pelvic deviation. For manual testing in clinical studies, leg length insufficiency testing was the most frequently used measurement index and the most common diagnostic results were anterior and posterior rotation. In the X-ray analysis, Obturator foramen and femur head line were the most frequently used measurement index and the most common diagnostic results were anterior rotation and posterior rotation. Conclusions The systematic review found that manual testing and X-ray analysis were mainly used for the diagnosis of pelvic deviation in CMT among clincial and review articles. As there was little research about diagnosing pelvic deviation in CMT and any existing research presented only low standards of evidence, further research should be updated with using a more standardized approach.

• Journal of Periodontal and Implant Science
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• 제53권2호
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• pp.99-109
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• 2023

Purpose: The aim of this systematic review was to evaluate the effectiveness of the socket shield technique (SST), an innovative surgical method introduced in 2010, for reducing buccal bone plate resorption. Methods: The review was conducted following the PRISMA guidelines. Clinical studies conducted in humans and investigating the SST were searched on PubMed (MEDLINE), Embase, Web of Knowledge, and Google Scholar in November and December 2021. The implant survival rate, percentage of complications, and clinical parameters (marginal bone loss [MBL], pink esthetic score [PES], and buccal bone plate resorption [BBPR]) were analyzed using the collected data. Results: The initial search resulted in 132 articles. After article screening, the full texts of 19 studies were read and 17 articles were finally included in the review. In total, 656 implants were installed with the SST. Nine of the 656 implants experienced failure, resulting in an implant survival rate of 98.6%. The percentage of complications was about 3.81%. The analysis of clinical parameters (MBL, PES, and BBPR), showed favorable results for the SST. The mean MBL in implants placed with the SST was 0.39±0.28 mm versus 1.00±0.55 mm in those placed without the SST. PES had a better outcome in the SST group, with an average of 12.08±1.18 versus 10.77±0.74. BBPR had more favorable results in implants placed with the SST (0.32±0.10 mm) than in implants placed with the standard technique (1.05±0.18 mm). Conclusions: The SST could be considered beneficial for preserving the buccal bone plate. However, since only 7 of the included studies were long-term randomized controlled trials comparing the SST with the standard implant placement technique, the conclusions drawn from this systematic review should be interpreted with caution.

• Imaging Science in Dentistry
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• 제54권1호
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• pp.13-24
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• 2024

Purpose: Pycnodysostosis (PYCD), an autosomal recessive syndrome, is characterized by an imbalance in bone remodeling that produces various clinical and radiographic craniofacial manifestations. This review represents a systematic examination of these manifestations, as well as oral features associated with PYCD. Materials and Methods: A systematic review was conducted across 8 databases from February to March 2023. The search strategy focused on studies reporting cases of PYCD that examined the clinical and radiographic craniofacial and oral characteristics associated with this syndrome. Results: The review included 84 studies, encompassing a total of 179 cases of PYCD. More than half of the patients were female (55.3%), and the mean age was 14.7 years. Parental consanguinity was reported in 51.4% of the cases. The most common craniofacial clinical manifestation was a prominent nose, observed in 57.5% of cases. Radiographically, the most frequently reported craniofacial characteristics included the presence of an obtuse mandibular angle (84.3%) and frontal cranial bosses(82.1%). Clinical and radiographic examinations revealed oral alterations, with micrognathia present in 62.6% of patients and malocclusion in 59.2%. Among dental anomalies, tooth agenesis was the most commonly reported, affecting 15.6% of patients. Conclusion: Understanding the clinical and radiographic craniofacial features of PYCD is crucial for dental professionals. This knowledge enables these clinicians to devise effective treatment plans and improve patient quality of life.

• 대한예방한의학회지
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• 제20권3호
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• pp.93-113
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• 2016

Objectives : The focus of the review was laid on differences in research pertaining to thread embedding acupuncture between domestic and foreign journals. Methods : We collected 53 Korean articles on thread embedding acupuncture study from 4 Korean article searching sites, and 80 foreign articles from Pubmed. We analyzed the number of the theses according to the publication year, study method, journal, and subject. Results : A total number of 134 thread embedding acupuncture articles were categorized as 100 clinical trials, 14 experimental papers, and 19 literature reviews. Of the collected clinical trials, 55 were case studies, 6 were CCTs and 39 were RCTs. The domestic clinical trials were comprised of 36 case studies, 1 CCT, and 2 RCTs, and foreign clinical trials were comprised of 19 case studies, 5 CCTs, and 37 RCTs. Although only 12 of the 39 domestic clinical trials exclusively treated thread embedding acupuncture to the experimental group, 38 out of 61 foreign clinical trials undertook thread embedding acupuncture as the sole treatment. While the 2 domestic RCTs research had no significant evidence that the experimental group was different from the control group, the experimental group demonstrated better responses than the control group in 31 of the 37 foreign RCT studies. Conclusions : Studies on thread embedding acupuncture are more intensively studied in the foreign field in comparison to the domestic field. Referring to the results from the foreign thread embedding acupuncture studies, domestic use of thread embedding acupuncture should be expanded. Also, more refined research needs to be conducted in the domestic field in order for the Koran medicine to lead the thread embedding acupuncture. This study is limited in that the literature search in the foreign journals were restricted.

• 한국병원경영학회지
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• 제14권1호
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• pp.62-98
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• 2009

A systematic review of the literatures was conducted to evaluate the effect of clinical practice guideline. The 77 studies were identified from a computerized search of published research on MEDLINE, Science-Direct and Blackwell synergy from January, 1997 to October, 2007. The main search terms were "clinical practice guideline" and "effectiveness", "clinical practice guideline" and "impact", "clinical practice guideline" and "evaluation". These studies were assessed the Quality twice by one Qualified expert and converted into weighted scale. The 63 studies were eligible inclusion criteria and subdivided into type of effect. Final indicator using for policy effect of clinical practice guidelines were classified as 4 categories; "improvement of outcomes" in 81 studies, "betterment in practice patterns" in 68 studies, "rationalization in resource utilization" in 84 studies and "cost containment" in 31 studies. The vote-counting method, one of meta-analysis method, was applied to summarized the effect of clinical practice guidelines and test statistically. From results of meta analysis, all indices were statistically significant. In conclusion, this meta-analysis showed that introduction of clinical practice guidelines were resulted positive outcomes in health policy.

• 대한한의학회지
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• 제42권3호
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• pp.99-118
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• 2021

Objectives: The aim of this study is to review and analyze the trends in prospective clinical research (PCR), project, clinical study protocol of Korean medicine (KM) for dementia. Methods: We searched PCRs of KM on dementia in six electronical databases, up to January 28, 2021. Moreover, the clinical research protocol and projects of KM for dementia were searched. Results: Total eight PCRs, nine projects, and three clinical study protocols were included. In the PCRs, there were one randomized controlled trial, five before and after study, and two comparative group before-after studies. Four of them used herbal medicine, two used acupuncture, one study used both herbal medicine and acupuncture, and the other one used moxibustion. Jowiseungchung-tang was the most frequently used herbal medicine. BL62, KI6 were used in electro-acupuncture, auricular-Shenmen in auricular acupuncture, and GV20 in moxibustion. The most frequent outcome was Korean-Dementia Rating Scale (K-DRS). One reported significant increase in K-DRS score, one reported 60% improvement, and the other studies mostly reported no significant difference. In the projects including 20 clinical studies of dementia, herbal medicine, integrative medicine and acupuncture were mainly used. In the protocols, herbal medicine, complex KM intervention, and integrative medicine were used. Conclusions: Currently, the number of PCRs of KM for dementia is very scarce. Therefore, the researcher's interest in this field and national research support should be made more, and the quality of clinical research in the future can be further improved by supplementing the limitations of previously published clinical research.

• 대한한방부인과학회지
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• 제22권1호
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• pp.279-302
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• 2009

Purpose: The aim of this study was to review systemically clinical trials on the trends of studies for Complementary Alternative Medicine in the treatment of dysmenorrhea. Methods: Through medical websites, foreign clinical literatures about complementary and alternative medicines of dysmenorrhea were searched. And domestic clinical literatures about dysmenorrhea, complementary and alternative treatment and oriental medicine treatment were searched using internet websites or hand-searching in National digital library, National assembly library, KISS, RISS. And then they were assessed by the assessment standard of Jadad scale and Classifying Recommendations. Results: 1. 15 foreign literatures and 36 domestic literatures were selected. 2. 4 foreign and 4 domestic clinical literatures were enough to satisfy over 2 points in Jadad score and recommendation level in Classifying Recommendations. 3. Some clinical trials were rated low in Jadad score since it was not easy to set control groups and keep blinding in clinical trials. 4. Some clinical trials were rated low in Classifying Recommendations since they did not carry out enough study about stability, side effect and follow-ups. Conclusion: To put clinical trials to practical use of Complementary Alternative Medicine in the treatment of dysmenorrhea, scientific and objective-based studies should be needed.