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Effect of Acupuncture on Sciatica in Rat Models: Systematic Review and Meta-analysis (좌골신경통 백서모델에서 침치료의 효과: 체계적 문헌고찰 및 메타분석)

  • Yoon, Ye-Ji;Kim, Soojeon;Cho, Jae-Heung;Kim, Koh-Woon;Song, Mi-Yeon
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.1
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    • pp.79-93
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    • 2020
  • Objectives While sciatic neuropathy is one of the common symptoms which have the lifetime incidence of 13~40%, still there is no consensus about the standardized and the most effective conservative treatment. In addition, the importance of systematic review and meta-analysis of preclinical are growing as they could suggest possible effective treatment strategy for future studies. Therefore, we conducted systematic review and meta-analysis to estimate analgesic effect of acupuncture on sciatica in rat models. Methods Systematic search was conducted for all controlled comparative preclinical trials which assessed analgesic effect of acupuncture in sciatica rat models. Database of PubMed, EMBASE, Web of Science, CNKI and 6 Korean databases were used. The primary outcome was pain, which is evaluated by stimulus behavior tests in rat models. We assessed the methodological quality with Systematic Review Centre for Laboratory Animal Experimentation's risk of bias tool. RevMan 5.3 was used for meta-analysis and subgroup analysis was conducted according to treatment site, acupuncture point, treatment period and frequency used in electroacupuncture. Results 14 studies were finally included following our inclusion criteria. The data from meta-analysis indicated that the acupuncture significantly improved the result values of behavior tests for pain evaluation, compared to no-treatment control group in animal models (standardized mean difference=4.43, 95% confidence interval 3.16 to 5.69, Z=6.84, p<0.00001; χ2=68.02, p<0.00001; I2=82%). The results of subgroup analysis indicate that acupuncture treatment of unilateral site, distal acupoints, longer treatment period and applying 2/100 Hz frequency in electroacupuncture could be more effective. Conclusions Systematic review and meta-analysis of animal studies are getting important for the future clinical studies and the improvement of heatlh care. Therefore the results of the study would provide evidence and better design for the forthcoming studies.

Clinical Practice Guideline on Acupuncture for Post-stroke Spasticity (뇌졸중후 경직에 대한 침치료 임상진료지침)

  • Kim, Je-Shin;Shin, Seung-Won;Lee, Eui-Ju;Shin, Byung-Cheul;Lee, Myeong-Soo;Lim, Sung-Min;Nam, Dong-Woo;Moon, Sang-Kwan
    • The Journal of Korean Medicine
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    • v.36 no.1
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    • pp.1-8
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    • 2015
  • Objectives: This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the patients with post-stroke spasticity. Methods: Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on post-stroke spasticity, compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions: One systematic review and 7 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of electroacupuncture treatment for post-stroke spasticity. However, it did not show any sufficient evidence to treat the patients with post-stroke spasticity with the sole acupuncture. The moderate evidence was presented that over 3 times of the electroacupuncture treatments with 1-100 Hz frequency should be performed every week on the acupoints, such as LI11, LI10, TE5, LI4, ST36, GB34, ST40, or LR3, for 20-30 minutes. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. Finally, there was a moderate evidence to support safety of acupuncture treatment for post-stroke spasticity.

The Efficacy of Acupuncture for Postoperative Pain in Patients with Solid Tumor : A Systematic Review and Meta Analysis (고형암 환자의 수술 후 통증에 대한 침 치료 효과 : 체계적 문헌고찰 및 메타분석)

  • Yoon, Sung Soo;Ryu, Han Sung;Oh, Hye Kyung;Lee, Jee Young;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.22 no.2
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    • pp.1-11
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    • 2017
  • Objectives: Postoperative pain is one of postoperative complications in patients with solid tumor. This systematic review and meta-analysis were aimed to evaluate the efficacy of acupuncture for postoperative pain in solid tumor. Methods: We searched for randomized controlled trials (RCTs) using acupuncture for postoperative pain in adult patients with solid tumor up to September 2016. Acupuncture was defined as manual acupuncture, electroacupuncture and pharmacopuncture. The following databases were searched: PubMed, EMBASE, Cochrane Library, CNKI, CiNii, KoreaMed, Kmbase, KISS, NDSL, KISTI. The results of the studies were meta-analyzed and the risk of bias was assessed. Results: Five studies were included in this review. When acupuncture was compared with usual care, Prince-Henry pain scale score was significantly lower in acupuncture group (MD=-0.44, 95% CI: -0.62 to -0.26, P<0.001, $I^2=87%$) and 10 points pain score (including Numeric Rating Scale and Visual Analog Scale) was lower in acupuncture group but not significantly (MD=-1.00, 95% CI: -2.00 to -0.00, p=0.05). When acupuncture was compared with sham acupuncture, 10 points pain score was significantly lower in acupuncture group (MD=-0.39, 95% CI: -0.65 to -0.14, p=0.002, $I^2=0%$). Any serious adverse events were not reported. Conclusion: This review shows that acupuncture may be considered for postoperative pain in patients with solid tumor without serious adverse events. However, only a few studies were included in this study, further investigation is needed in this area.

Psychosocial Interventions for Children and Adolescents after a Disaster: A Systematic Literature Review (1991-2015) (재난 후 소아청소년의 정신사회적 개입: 체계적 문헌고찰(1991~2015))

  • Lee, Mi-Sun;Hwang, Jun-Won;Lee, Cheol-Soon;Kim, Ji-Youn;Lee, Ju-Hyun;Kim, Eunji;Chang, Hyoung Yoon;Bae, Seung-Min;Park, Jang-Ho;Bhang, Soo-Young
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.27 no.4
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    • pp.278-305
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    • 2016
  • Objective: The aim of this systematic literature review is to analyze the psychosocial interventions for children and adolescents after disasters. Methods: We conducted a review of the extant research literature from 1991 to 2015 via a comprehensive search of the MEDLINE, EMBASE, Cochrane CENTRAL, PubMed and PsyclNFO databases. The keywords employed in this research included: 'child', 'adolescent', 'youth', 'disaster', 'posttraumatic', 'psychosocial', 'therapy' and 'intervention'. The researchers followed the PRISMA guidelines. A total of 850 articles were screened for their eligibility and fifty-nine were found to meet the study criteria. The final data analysis was performed based on the disaster type, study design, type of intervention, sample size, age, school grade, number of sessions, setting of intervention delivery, providers, approach and parent involvement. Results: Countries worldwide have experienced various kinds of disasters, including earthquakes, hurricanes, vessel accidents, tornados, tsunamis, volcanic eruptions, war, fire, terrorism, and traffic accidents. The types of psychosocial intervention that were conducted after these disasters included: psychological first aid, psychological debriefing, psychoeducation, trauma focused cognitive behavior therapy, eye movement desensitization reprocessing, prolonged exposure therapy, group play therapy and arts therapy, project interventions, school-based interventions and web-based interventions. Conclusion: The findings of the systematic literature review suggest that an appropriate psychosocial intervention could be utilized as evidence-based mental health treatment for children and adolescents after disasters.

A Review of Acupuncture Treatment Methods for Lumbar Herniated Intervertebral Disc

  • Kim, Sung Jin;Jeong, Seong Mok;Lee, Chang Hee;Yoon, Jin-Young;Shim, Sung Eun;Kim, Jeong Hyon;Goo, Bon Hyuk;Park, Yeon Cheol;Baek, Yong-Hyun;Nam, Sang Soo;Seo, Byung-Kwan
    • Journal of Acupuncture Research
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    • v.35 no.4
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    • pp.158-168
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    • 2018
  • The purpose of this study was to review clinical studies of lumbar herniated intervertebral disc (LHIVD) treatment using acupuncture. Online database (PubMed, COCHRANE Library, EMBASE, CNKI, KISS, NDSL, KoreaMed, KMbase, OASIS, and KISTI) searches were conducted in May 2018. Studies that used acupuncture, electroacupuncture or warm needle acupuncture were included, along with participants who had lower back pain and radiating pain of their lower limbs consistent with radiological findings. Animal studies and nonclinical data were excluded. Data on treatment methods, site, time, frequency, period, and scales used were analyzed. There were 69 studies including 38 randomized controlled trials, 14 retrospective observational studies, and 17 clinical case studies. There were 51 acupoints selected for acupuncture treatment of LHIVD. The most frequently treated acupoints were BL23, BL25, BL24, and BL40. The mean treatment time, frequency, and duration were $26.06{\pm}6.70$ mins, $6.29{\pm}1.70$ times/week, and $20.57{\pm}11.04$ days, respectively, in randomized controlled trials (RCT), and $18.62{\pm}4.60$ mins, $11.58{\pm}3.99$ times/week, and $34.43{\pm}17.62$ days, respectively, in case/retrospective studies ($mean{\pm}SD$). This review collates information about acupuncture treatment methods for LHIVD.

Treatment Strategies for Psychotic Depression (정신병적 우울증의 치료 전략)

  • Lee, Soyoung Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.13 no.4
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    • pp.234-243
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    • 2006
  • Objectives : Several factors, such as biological markers, clinical correlates, and course of the depressive disorders with psychotic symptoms differ from those without psychotic symptoms. Therefore, specification of a treatment algorithm for depressive disorder with psychotic symptoms is legitimated. This article provides a systematic review of somatic treatments for depressive disorder with psychotic symptoms. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, first, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders with psychotic symptoms(until July 2006). Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Treatment options, such as a combination of an antidepressant and an antipsychotic versus an antidepressant or an antipsychotic alone are summarized. In addition, issues regarding the electroconvulsive therapy( ECT), combination therapy, and maintenance treatment are discussed. Conclusion : In former times, the combination of an antidepressant and an antipsychotic or ECT were recommended as the first line treatment for depressive disorder with psychotic symptoms. Recently, however, there was a suggestion that there was no conclusive evidence that the combination of an antidepressant and an antipsychotic drug is more effective than an antidepressant alone. More evidence regarding the pharmacological treatment for depressive disorder with psychotic symptoms is needed.

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Root coverage using a coronally advanced flap with or without acellular dermal matrix: a meta-analysis

  • Guan, Wei;Liao, Haiqing;Guo, Li;Wang, Changning;Cao, Zhengguo
    • Journal of Periodontal and Implant Science
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    • v.46 no.1
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    • pp.22-34
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    • 2016
  • Purpose: Gingival recession is a major esthetic concern and may lead to root sensitivity during periodontal treatment. Coronally advanced flaps (CAFs) with and without acellular dermal matrix (ADM) are widely used in root coverage procedures. The aim of this study was to analyze the efficacy of CAF in combination with ADM in the treatment of gingival recession. Methods: PubMed, The Cochrane Library, and Embase were used to identify relevant articles. The articles were screened, data were extracted, and the quality of the studies was assessed by three reviewers with expertise in clinical practice, trials, statistics, and biomedical editing. The clinical endpoints of interest included changes in recession, probing depth (PD), clinical attachment level (CAL), and keratinized tissue (KT). Results: Ten randomized controlled trials were identified, including six studies that compared CAFs with ADM and CAFs using connective tissue grafting (CTG) and four studies that compared CAFs with or without ADM. No statistically significant differences were found between the use of ADM and CTG, whereas statistically significant differences were found between groups in which ADM and CAF were combined and groups that underwent CAF alone with regard to recession coverage, CAL, and KT. The combination of CAF with an ADM allograft achieved more favorable recession coverage and recovery of CAL and KT than CAF alone. Conclusions: The results from the ADM and CTG groups suggest that both procedures may be equally effective in clinical practice. Given the limitations of this study, further investigation is needed to clarify the effectiveness of ADM and CAF in clinical practice.

Effect of luteal phase support with vaginal progesterone on pregnancy outcomes in natural frozen embryo transfer cycles: A meta-analysis

  • Seol, Aeran;Shim, Yoo Jin;Kim, Sung Woo;Kim, Seul Ki;Lee, Jung Ryeol;Jee, Byung Chul;Suh, Chang Suk;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.2
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    • pp.147-152
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    • 2020
  • Objective: The purpose of this study was to determine the effect of vaginal progesterone for luteal phase support (LPS) on the clinical pregnancy rate (CPR) in natural frozen embryo transfer (FET) cycles via a meta-analysis. Methods: We performed a meta-analysis of randomized controlled trials (RCTs) and retrospective studies that met our selection criteria. Four online databases (PubMed, Embase, Medline, and the Cochrane Library) were searched between January 2017 and May 2017. Studies were selected according to predefined inclusion criteria and meta-analyzed using R software version 2.14.2. The main outcome measure was CPR. Results: A total of 18 studies were reviewed and assessed for eligibility. One RCT (n = 435) and three retrospective studies (n = 3,033) met the selection criteria. In a meta-analysis of the selected studies, we found no significant difference in the CPR (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.60-1.55) between the vaginal progesterone and control groups. An analysis of the two retrospective cohort studies that reported the live birth rate (LBR) following FET showed a significantly higher LBR in the vaginal progesterone group (OR, 1.72; 95% CI, 1.21-2.46). A subgroup meta-analysis of FET conducted 5 days after injection of human chorionic gonadotropin showed no significant differences between the two groups with regard to the CPR (OR, 1.18; 95% CI, 0.90-1.55) or miscarriage rate (OR, 0.73; 95% CI, 0.36-1.47). Conclusion: The results of this meta-analysis of the currently available literature suggest that LPS with vaginal progesterone in natural FET cycles does not improve the CPR.

Effect of $SLCO1B1^*15$ on Pravastatin Pharmacokinetics: A Systematic Review and Meta-analysis (프라바스타틴에서 $SLCO1B1^*15$의 약동학적 영향: 체계적 고찰 및 메타분석)

  • Kim, Jong Yoon;Nakagawa, Naoto;Yoon, Hyonok;Chun, Pusoon;Rhew, Ki Yon
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.4
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    • pp.231-239
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    • 2014
  • Background and objective: Pravastatin has been shown to have favorable risk-benefit profile when it is administered to hypercholesterolemic subjects to prevent cardiovascular events. However, subjects with impaired OATP1B1 activity may be more susceptible to pravastatin-induced muscle toxicity than subjects with normal OATP1B1 activity. A systematic review was conducted to evaluate the effect of SLCO1B1 genetic polymorphism on pharmacokinetics of pravastatin. Method: Medline$^{(R)}$ and Embase$^{(R)}$ were searched for relevant studies until July 2013. The search terms used were pravastatin AND (SLCO1B1 OR OATP1B1 OR LST1 OR SLC21A6) AND (gene OR $genetic^*$ OR $genomic^*$ OR $pharmacogenet^*$ OR $pharmacogenom^*$ OR $polymorph^*$). Results: A meta-analysis of the area under the concentration-time curve (AUC) of pravastatin in $SLCO1B1^*15$ and $SLCO1B1^*1a/^*1a$ was conducted. Five studies met all the inclusion criteria and methodological requirements. There was no statistically significant difference in the AUC value between $SLCO1B1^*15$ and $SLCO1B1^*1a/^*1a$ (p=0.728). However, $SLCO1B1^*15$ participants exhibited significantly higher AUC values than $SLCO1B1^*1b/^*1b$ carriers (p<0.001). In case of $SLCO1B1^*15^*15$ carriers, they had significantly higher AUC value than $SLCO1B1^*1a/^*1a$ subjects (p=0.002). Lastly, compared with to the subjects of $SLCO1B1^*1a/^*1a$, the carriers of heterozygous $SLCO1B1^*15$ increased the AUC value of pravastatin statistically significantly in Asian population (p=0.014). Conclusion: The present meta-analysis suggests that subjects with $SLCO1B1^*15$ are associated with increased AUC of pravastatin.

Effect of cassia cinnamon intake on improvement of the glycemic response: An updated meta-analysis - Focus on preparation of dehydrated powder and water extract (계피의 혈당 개선 기능성 평가 : 메타분석 - 건조분말과 물추출물을 중심으로)

  • Kwak, Jin Sook;Park, Min young;Kwon, Oran
    • Journal of Nutrition and Health
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    • v.50 no.5
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    • pp.437-446
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    • 2017
  • Purpose: This meta-analysis aimed to evaluate the effect of cassia cinnamon (Cinnamomum. cassia and C. aromaticum) on the glycemic response with a focus on the preparation of dehydrated powder and water extract. Methods: We searched Pubmed, Cochrane, EMBASE, Science Direct, and the Korean Studies Information Service System (KISS) through May 2017. In the meta-analysis for the preparation of powder, eight trials reporting fasting blood glucose (FBG), four trials reporting HbA1c, and three trials reporting the postprandial glycemic response were included. For the water extract, six trials reporting FBG and four trials reporting HbA1c were eligible for this study. A random-effects model was used to calculate the pooled effect size. Results: Cassia cinnamon powder intake significantly lowered FBG by -1.55 mmol/L (95% CI, -2.45, -0.64; p = 0.001) and the AUC of postprandial blood glucose level by $-51.8mmol/L{\cdot}min$ (95% CI, -85.5, -18.1; p = 0.003). There was a significant difference in FBG between water extract of cinnamon and placebo of -0.76 mmol/L (95% CI, -1.09, -0.43; p = 0.000). However, blood HbA1c level was not significantly altered by any preparation of cinnamon. No statistical heterogeneity was observed for any analysis except in the case of FBG for cinnamon powder. Results of funnel plots and Egger's regression suggest a low likelihood of publication bias in all biomarkers (p > 0.05). Conclusion: According to this meta-analysis, there was possible evidence to support a relationship between cassia cinnamon intake and fasting glucose in both preparation of powder and water extract. Furthermore, new evidence of the health benefits on postprandial glucose regulation of cinnamon powder was obtained.