• Title/Summary/Keyword: Exclusion Period

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Long-term Survival Outcomes of Laparoscopic Gastrectomy for Advanced Gastric Cancer: Five-year Results of a Phase II Prospective Clinical Trial

  • Ahn, Sang-Hoon;Kang, So Hyun;Lee, Yoontaek;Min, Sa-Hong;Park, Young Suk;Park, Do Joong;Kim, Hyung-Ho
    • Journal of Gastric Cancer
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    • v.19 no.1
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    • pp.102-110
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    • 2019
  • Purpose: Despite an increased acceptance of laparoscopic gastrectomy (LG) in early gastric cancer (EGC), there is insufficient evidence for its oncological safety in advanced gastric cancer (AGC). This is a prospective phase II clinical trial to evaluate the feasibility of LG with D2 lymph node dissection (LND) in AGC. Materials and Methods: The primary endpoint was set as 3-year disease-free survival (DFS). The eligibility criteria were as follows: 20-80 years of age, cT2N0-cT4aN3, American Society of Anesthesiologists score of 3 or less, and no other malignancy. Patients were enrolled in this single-arm study between November 2008 and May 2012. Exclusion criteria included cT4b or M1, or having final pathologic results as EGC. All patients underwent D2 lymphadenectomy. Three-year DFS rates were estimated by the Kaplan-Meier method. Results: A total of 157 patients were enrolled. The overall local complication rate was 10.2%. Conversion to open surgery occurred in 11 patients (7.0%). The mean follow-up period was $55.0{\pm}20.4months$ (1-81 months). The cumulative 3-year DFS rates were 76.3% for all stages, and 100%, 89.3%, 100%, 88.0%, 71.4%, and 35.3% for stage IB, IIA, IIB, IIIA, IIIB, and IIIC, respectively. Recurrence was observed in 37 patients (23.6%), including hematogenous (n=6), peritoneal (n=13), locoregional (n=1), distant node (n=8), and mixed recurrence (n=9). Conclusions: In addition to being technically feasible for treatment of AGC in terms of morbidity, LG with D2 LND for locally advanced gastric cancer showed acceptable 3-year DFS outcomes.

Effect of Cardiopulmonary Physiotherapy on Patients With Percutaneous Coronary Intervention - Systematic Review and Meta-Analysis (경피적 관상동맥 중재술을 받은 환자를 대상으로 심장호흡물리치료에 대한 효과 - 체계적 고찰과 메타분석)

  • Kang, Na-yoon;Park, Beom-seok;Kim, Min-hee
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.1
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    • pp.63-73
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    • 2019
  • PURPOSE: This study examined the effects of cardiopulmonary physiotherapy on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI). METHODS: Electronic bibliographic databases of a regional information sharing system (RISS) and PubMed were searched to identify studies with randomized and non-randomized controlled trials. As the final outcome, 320 publications were identified and 18 studies met the inclusion and exclusion criteria. All studies were assessed for the quality of study using Cochrane's risk of bias. RESULTS: Sixteen studies met the inclusion criteria, in which meta-analysis had been conducted to examine the effectiveness of cardiopulmonary physiotherapy on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients undergoing PCI. Meta-analysis based on a random effect model showed that the cardiopulmonary physiotherapy was beneficial in improving the cardiopulmonary function, metabolism, inflammatory markers, and quality of life. In particular, there was a significant effect on the peak oxygen uptake (effect size 5.30%; 95% confidence interval 3.62~6.97). Cardiopulmonary physiotherapy for a during period of 6 weeks or more was effective in significantly improving the cardiopulmonary function and metabolism function in a subgroup analysis, but cardiopulmonary physiotherapy for less than 6 weeks was not effective. CONCLUSION: Cardiopulmonary physiotherapy has positive effects on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients undergoing PCI.

Systematic Review of Acupuncture Treatment for Mild Cognitive Impairment

  • Kim, Min Wook;Yoo, Jae Hee;Go, Hong Je;Kim, Seon Woo;Jang, Seung Won;Jeong, Hyun Jin;Kim, Jae Hong
    • Journal of Acupuncture Research
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    • v.36 no.2
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    • pp.72-79
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    • 2019
  • Background: The aim of this study was to review clinical efficacy of acupuncture treatment of mild cognitive impairment. Methods: Randomized controlled trials that performed acupuncture treatment for mild cognitive impairment were retrieved from 6 online databases (PubMed, Cochrane Library, EMBASE, CNKI, NDSL, OASIS) on September $30^{th}$, 2018. Studies were selected according to inclusion and exclusion criteria, and were reviewed by Risk of Bias assessment. Results: In total, 21 studies were included in this review. All studies were Chinese (19 studies published in Chinese and 2 in English). The sample size, 50 to 100, and the number of treatment times, 20 to 30, were the largest range in all studies. The most treatments performed was 30. The longest treatment period was 56 days, which accounted for 33% of the studies. The most frequently used evaluation index was the Mini Mental State Examination followed by the Montreal Cognitive Assessment, each used 17 times and 15 times, respectively. The most frequently used acupoints were GV20, EX-HN1, GB20, and GV24, which accounted for 47% of total number of acupoints used. In 48% of the studies, needle retention time was 30 minutes. Western medicine treatment was the most common control group. Most studies reported that the intervention group was statistically significantly different to the control group. Conclusion: These results suggest that acupuncture for mild cognitive impairment was effective. However, it is difficult to confirm this conclusion because the quality of most of these studies were of low quality.

Mid-term Clinical and Radiological Outcomes of Latissimus Dorsi Tendon Transfer in Massive Rotator Cuff Tears

  • Suh, Dongwhan;Ji, Jong-Hun;Tankshali, Kirtan;Kim, Eung-Sic
    • Clinics in Shoulder and Elbow
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    • v.22 no.4
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    • pp.220-226
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    • 2019
  • Background: This retrospective study was undertaken to evaluate mid-term clinical and radiological outcomes of lattisimus dorsi (LD) tendon transfer in patients with irreparable massive rotator cuff tears (MRCT). We hypothesize that LD tendon transfer would provide safe and satisfactory clinical outcomes at mid-term follow-up. Methods: From November 2008 to December 2016, 23 patients ($57.5{\pm}4.4years$; 20 male, 3 female) who underwent LD tendon transfer for massive tears, were enrolled. Inclusion criteria were irreparable MRCT. Exclusion criteria included full thickness subscapularis tear, rotator cuff arthropathy, anterosuperior rotator cuff tear, and osteoarthritis. Mean follow-up period was $4.7{\pm}4.0years$ (range, 2-12 years). Clinical assessment (American Shoulder and Elbow Surgeons [ASES], University of California, Los Angeles [UCLA], Simple Shoulder Test [SST]) and radiographic assessment (osteoarthritis [OA], acromiohumeral distance [AHI]) were evaluated. Results: ASES, UCLA and SST scores, and range of motion (ROM), except internal rotation, improved significantly at the last followup (p<0.05). Also, AHI was significantly improved at the last follow-up, from 6.6 mm to 8.2 mm (p=0.008). At the final follow-up, the radiologic stages of the glenohumeral osteoarthritis were determined as stage 1 in 9 patients, stage 2 in 10 patients, stage 3 in 2 patients, and stage 4 in 2 patients. Complications were observed in 21.7% cases: 3 re-tears and 2 infections were noted in our study. Conclusions: LD tendon transfer for irreparable MRCT provides satisfactory clinical outcomes at mid-term follow-up. Mild degenerative osteoarthritis (stage 1, 2) of the shoulder joint are common at the mid-term follow-up. Also, complications such as tear, infection should be considered.

Psychosocial support interventions for women with gestational diabetes mellitus: a systematic review

  • Jung, Seulgi;Kim, Yoojin;Park, Jeongok;Choi, Miyoung;Kim, Sue
    • Women's Health Nursing
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    • v.27 no.2
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    • pp.75-92
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    • 2021
  • Purpose: This study aimed to analyze the content and effectiveness of psychosocial support interventions for women with gestational diabetes mellitus (GDM). Methods: The following databases were searched with no limitation of the time period: Ovid-MEDLINE, Cochrane Library, Ovid-Embase, CINAHL, PsycINFO, NDSL, KoreaMed, RISS, and KISS. Two investigators independently reviewed and selected articles according to the predefined inclusion/exclusion criteria. ROB 2.0 and the RoBANS 2.0 checklist were used to evaluate study quality. Results: Based on the 14 selected studies, psychosocial support interventions were provided for the purpose of (1) informational support (including GDM and diabetes mellitus information; how to manage diet, exercise, stress, blood glucose, and weight; postpartum management; and prevention of type 2 diabetes mellitus); (2) self-management motivation (setting goals for diet and exercise management, glucose monitoring, and enhancing positive health behaviors); (3) relaxation (practicing breathing and/or meditation); and (4) emotional support (sharing opinions and support). Psychosocial supportive interventions to women with GDM lead to behavioral change, mostly in the form of self-care behavior; they also reduce depression, anxiety and stress, and have an impact on improving self-efficacy. These interventions contribute to lowering physiological parameters such as fasting plasma glucose, glycated hemoglobin, and 2-hour postprandial glucose levels. Conclusion: Psychosocial supportive interventions can indeed positively affect self-care behaviors, lifestyle changes, and physiological parameters in women with GDM. Nurses can play a pivotal role in integrative management and can streamline the care for women with GDM during pregnancy and following birth, especially through psychosocial support interventions.

A Systematic Review on the Physical Rehabilitation of Children with Cerebral Palsy: Focusing on Domestic Literature

  • Kwon, Ae-Lyeong;Kim, Ki-Jeon
    • The Journal of Korean Physical Therapy
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    • v.34 no.5
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    • pp.198-204
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    • 2022
  • Purpose: This paper sought to classify, analyze, and investigate domestic research papers on the physical rehabilitation of children with cerebral palsy, and to suggest a direction for rehabilitation after the coronavirus disease 2019 (COVID-19) pandemic. Methods: A literature search was conducted from June 1 to June 30, 2022, and only papers published in domestic journals during the past 10 years were searched. The main search term was "rehabilitation for children with cerebral palsy", and "rehabilitation" such as "exercise rehabilitation," "equestrian rehabilitation", and "aquatic rehabilitation" were reviewed when they appeared in the titles and abstracts. A total of 18 books were selected according to the exclusion criteria. Results: Rehabilitation by area was divided into exercise rehabilitation, Bobath rehabilitation, equestrian rehabilitation, and aquatic rehabilitation. Analysis was undertaken based on the period of rehabilitation, area wise from 2012 to 2017, except for aquatic rehabilitation, which was studied once in 2020. The intervention effects of exercise rehabilitation were summarized as PICO (Participants, Intervention, Comparison, Outcome), and most of the studies showed improvements in the subject's physical functions. Conclusion: Research on the physical rehabilitation of children with cerebral palsy is being conducted in multiple directions and through several methods. In addition to the Bobath and Vojta approaches, equestrian rehabilitation, aquatic rehabilitation using the buoyancy of water, and computer rehabilitation are conducted. For the physical rehabilitation of children with cerebral palsy in the context of COVID-19, programs that are linked with families and those that incorporate Information Communications Technology (ICT) could be developed.

Effect of Mask Filter on Respiratory Function in Chronic Stroke Patients (마스크 필터가 만성 뇌졸중 환자의 호흡기능에 미치는 영향)

  • Lee, Yun-Hee;Kum, Dong-Min;Shin, Won-Seob
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.1
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    • pp.149-155
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    • 2022
  • Purpose : This study investigated the effects of wearing a mask and different mask filters on the respiratory function of stroke patients. Methods : A total of 15 stroke patients were selected according to the inclusion and exclusion criteria. The respiratory functions were compared between participants with and without masks and among respiratory functions with three different mask filters. The order of using masks was non-wearing masks, Dental masks, KF80 masks, and KF94 masks; the difference in respiratory volumes among these conditions were measured. For accuracy of the measurement, sufficient education on the respiratory measurement method was provided to the researcher, and the heart rate of the participants was estimated to confirm their stability before the measurements. To ensure accuracy, the subjects were educated on the researchers' respiratory measurement methods. Each measurement was followed by 10 min breathing stability before replacing the next mask. Results : The results of this study showed that the difference in respiratory functions, including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and maximal voluntary ventilation (MVV), in stroke patients was statistically significant among different masks (p<.05). Afterwards, the values of FVC, FEV1, and MVV in stroke patients wearing masks were significantly lower than those of the non-masked control group (p<.05). The difference in respiratory functions with different mask filters showed no statistical significance (p<.05). Conclusion : This study showed that participants wearing any of the masks presented a lower respiratory function than that of those without using masks; additionally, no difference in respiratory functions was observed with differences in mask filters. Therefore, wearing a mask for a prolonged period is confirmed to affect breathing in stroke patients with weak respiratory function.

A Study on the Precedents Changing Related to Using Medical Devices of Korean Medicine Doctors (한의사 의료기기 사용과 관련된 판례 및 기존 연구 분석과 경향 변화)

  • Park, Jeongsu;Oh, Kichang;Kwon, Sanghyuk;Chu, Hongmin;Kim, Jungsang
    • The Journal of Internal Korean Medicine
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    • v.42 no.6
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    • pp.1303-1318
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    • 2021
  • Objectives: The aim of this study was to examine the debate on the use of medical devices between Western Medicine and Korean Medicine, as this is one of the greatest conflicts in Korea's medical profession. Judicial precedents and interpretations of authority serve as regulations because medical affairs law states that Korean Medicine practices are ambiguous. Method: We conducted a search in the Korean RISS, OASIS, and DBPIA databases using several keywords associated with medical devices, Korean Medicine, and Korean Medicine Doctors. The search period was until November 5 2021. The retrieved papers were classified according to the selection and exclusion criteria by checking the title, abstract, and text. For precedents, searches were done regarding comprehensive legal information, etc., and in the case of non-disclosure precedents, we requested access to the precedents by web-court requests. Results: A total of 80 documents were found as a result of the search, and 13 publications were included in the study. The selected publications were classified and analyzed by this research team into Korean medicine, Western medicine, and legal or state agency research. In the existing literature and judgments, the arguments that played a major role changed depending on the time the judgment was made. "Social conventions", "curriculum", "academic principles", and "health and hygiene dangers" were the key arguments. Conclusions: Further studies will be needed that can comprehensively arrange the existing literature and clinical results, and continuous study will be needed to verify that the use of medical devices by Korean medicine doctors is helpful for prognosis and accurate treatment of their patients.

Clinical Research Trends of Gut Microbiome for Respiratory Diseases (호흡기질환에 대한 장내 미생물의 임상 연구 동향)

  • Lee, Su Won;Choi, Jin Kwan;Yang, Won Kyung;Kim, Seung Hyung;Lyu, Yee Ran;Park, Yang Chun
    • The Journal of Korean Medicine
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    • v.42 no.3
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    • pp.119-138
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    • 2021
  • Objectives: This study aimed to review the clinical research of the gut microbiome for respiratory diseases to assist the design of trials for respiratory diseases by regulating the gut microbiome with herbal medicine later. Methods: We searched three international databases (PubMed, CENTRAL and EMBASE) to investigate randomized controlled trials (RCTs) of the gut microbiome for respiratory diseases. The selected trials were analyzed by study design, subject diseases, inclusion/exclusion criteria, sample size, study period, intervention group, control group, outcome measures, and study results. Results: A total of 25 studies were included and published from 1994 to 2021 mostly in Europe and Asia. Subject diseases were many in the order of respiratory tract infection, cystic fibrosis, allergy, and so on. As outcome measures, the gut microbiome in a fecal sample was analyzed by 16S rRNA sequencing analysis method, and symptom assessment tools related each disease were used. Major intervention drugs were probiotics and the results were mostly improved in the composition and diversity of the gut microbiome. Conclusion: Clinical studies of the gut microbiome for respiratory diseases have confirmed various effects and this review provides basic data for a well-designed clinical study for respiratory diseases by regulating the gut microbiome with herbal medicine.

Effects of steroid injection during rehabilitation after arthroscopic rotator cuff repair

  • Ha, Joong-Won;Kim, Hyunkyo;Kim, Seong Hun
    • Clinics in Shoulder and Elbow
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    • v.24 no.3
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    • pp.166-171
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    • 2021
  • Background: This study aims to compare the clinical outcomes of steroid injections during the rehabilitation period after arthroscopic rotator cuff repair (ACRC). Methods: Among patients who underwent ARCR, 117 patients who met the inclusion and exclusion criteria were enrolled. Pain and range of motion (ROM) recovery at the 3-, 6-, and 24-month follow-up visits and functional outcome at the 24-month follow-up were compared between 45 patients who received ultrasound-guided subacromial steroid injection at postoperative week 4 or 6 and 72 patients who did not. Functional outcome was assessed using the American Shoulder and Elbow Surgeons (ASES) score and Constant score. Healing of the repaired tendon and retear were observed at the 6-month follow-up via magnetic resonance imaging (MRI) or computed tomography (CT) arthrography. Results: At the 3-month follow-up, the steroid injection group showed lower visual analog scale scores than the control group (p<0.05) and showed faster recovery of forward flexion and internal rotation (p<0.05). From the 6-month follow-up, the two groups did not show differences in pain and ROM, and the ASES score and Constant score also did not significantly differ at the 24-month follow-up. The two groups did not differ in retear rate as determined by MRI or CT arthrography at the 6-month follow-up. Conclusions: This study demonstrated that ultrasound-guided subacromial steroid injection at 4 or 6 weeks after ARCR leads to quick pain reduction and ROM recovery until 3 months after surgery. Therefore, subacromial steroid injection is speculated to be an effective and relatively safe method to assist rehabilitation.