• 한국임상약학회지
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• 제21권4호
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• pp.364-375
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• 2011

Given that single blockade with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) can achieve only partial and undurable suppression of the Renin Angiotensin System (RAS), it has been hypothesized that dual blockage would be more beneficial in the management of blood pressure (BP) reduction and prevention of progressive chronic kidney disease (CKD) than either agent alone. Thus, it has been suggested that the combination of an ACEI and an ARB might provide renal benefits to hypertensive patients over and above BP reduction. However, this might also expose patients to additive or synergistic side effects. We attempted to conduct a systematic review to evaluate the benefits and harms of combination therapy in hypertensive patients with or without kidney diseases. MEDLINE and KoreaMed were searched for relevant randomized clinical trials in adult hypertensive patients with or without diabetes (restricted to 1997, limited to trials published in English). Results were summarized using the random-effects model, and between-studies heterogeneity was estimated with $I^2$. A final analysis of ten trials (23,928 patients) revealed that the combination of an ACEI and an ARB reduced blood pressure (SBP/DBP) by 3.95/2.02 mmHg (95% confidence interval [CI], -4.38 to -3.53/-2.33 to -1.71) compared with ACEI monotherapy, and 2.83/2.64 mmHg (95% CI, -3.25 to -2.41/-4.95 to -0.33) compared with ARB monotherapy. Eight trials (391 patients) demonstrated a significant reduction in 24h-proteinuria (weighted mean difference, 0.16 g/day, 95% CI, -0.26-0.05), but they did not translate into an improvement in GFR. Tests for heterogeneity showed no difference in effect among the studies. The combination therapy reduced proteinuria by 30% (95% CI, 23% to 37%) and 39% (95% CI, 31% to 48%) compared with ACEI monotherapy and ARB monotherapy, respectively. However, in patients who had proteinuria more than 0.5 g/day, the combination therapy failed to show significant reduction in urinary protein excretion. The current cumulative evidence suggests that diabetic patients with proteinuria on dual RAS blockade have an increase risk of adverse events such as hyperkalemia, hypotension, and so on, compared with ACEI or ARB alone. It is, therefore, proposed that the combination therapy should not be routinely used for the treatment of hypertension with or without compelling indications.

• PNF and Movement
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• 제6권1호
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• pp.33-40
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• 2008

Purpose : When the pliability of the Lumbar is degraded, the kinesiology function undergoes an influence and it receives an overload. Finally, it is connected with a Lumbar muscular injury. When it does the regular exercise treatment the lumbago patient the balance and function of changeover are improved. The purpose of this study is to review of effect of the PNF application for lumbago patient Methods : By using internet, we research the PubMed, Science Direct, KISS, DBpia and the article on the effect of PNF. We selected the article between 1970 and 2007. Key words were low back pain, lumbago, PNF. Results : PNF is a therapeutic exercise for central nervous system(CNS) patient and the peripheral nervous system(PNS) patient and it is widely applied from sports medicine in the last. According to research of the Jung Young Jo(2007) and Han Kou Soo(2002), PNF technique improves the pain and a condition of the lumbago patient. And the affection balanced change and dynamic balance change and spontaneous movable scope are improved. And it improved to daily life activity. According to research of Moore and Hutton(1980), Lee Kyoung Hye(1999), PNF stretching where it is one of muscular relaxation is good in lumbar muscle fascia ache solutions, and PNF stretching that muscle is relaxed and increases ROM by Reflective system of the vertebra. These researches is relation all each other. it have appeared many report of research about Pliability, muscular power, balance, mobility improve ADL movement of attendance ability and functional action improved excise therapy put effect about lumbago patient recently, it have appeared research about therapy of lumbago patient through PNF. But PNF technique is not application about lumbago patient in clinic, therefore also it is not enough for case study about this therapy. Conclusion : PNF improve combination operation of muscle, inconvenience decrease from daily life activity, ROM(range of movement) of lumbar is increase and Lumbago reduce. So we suggest that PNF will be applies on the lumbago patient and must do a many research.

• Imaging Science in Dentistry
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• 제47권3호
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• pp.165-174
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• 2017

Purpose: This study was performed to investigate the influence of object shape and distance from the center of the image on the volumetric accuracy of cone-beam computed tomography (CBCT) scans, according to different parameters of tube voltage and current. Materials and Methods: Four geometric objects(cylinder, cube, pyramid, and hexagon) with predefined dimensions were fabricated. The objects consisted of Teflon-perfluoroalkoxy embedded in a hydrocolloid matrix (Dupli-Coe-Loid TM; GC America Inc., Alsip, IL, USA), encased in an acrylic resin cylinder assembly. An Alphard Vega Dental CT system (Asahi Roentgen Ind. Co., Ltd, Kyoto, Japan) was used to acquire CBCT images. OnDemand 3D (CyberMed Inc., Seoul, Korea) software was used for object segmentation and image analysis. The accuracy was expressed by the volume error (VE). The VE was calculated under 3 different exposure settings. The measured volumes of the objects were compared to the true volumes for statistical analysis. Results: The mean VE ranged from -4.47% to 2.35%. There was no significant relationship between an object's shape and the VE. A significant correlation was found between the distance of the object to the center of the image and the VE. Tube voltage affected the volume measurements and the VE, but tube current did not. Conclusion: The evaluated CBCT device provided satisfactory volume measurements. To assess volume measurements, it might be sufficient to use serial scans with a high resolution, but a low dose. This information may provide useful guidance for assessing volume measurements.

• 한방안이비인후피부과학회지
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• 제28권3호
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• pp.30-47
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• 2015

Objective : Melanoma is a very critical and devastating disease. Although many people have depended on surgical operation in melanoma treatment, they have placed importance on non-invasive methods constantly. So we planned to establish a research methodology by analysing existing articles containing conservative melanoma treatments in Journals of Korean Medicine published in Korea.Methods : Using search words of anti-cancer, B16, cancer, lung metastasis, melanoma, metastasis, S-100, SK-MEL, tumor, tyrosinase, we collected 26 articles by searching internet portal sites as following;Using search words of anti-cancer, B16, cancer, lung metastasis, melanoma, metastasis, S-100, SK-MEL, tumor, tyrosinase, we collected 26 articles by searching internet portal sites as followinghttp://oasis.kiom.re.kr,http://www.koreantk.com,http://www.riss.kr,http://www.dbpia.co.kr,http://www.ndsl.kr,http://kiss.kstudy.com,http://www.naver.com,http://www.google.com.Result : The number of articles is 26 and in the year of 2003, 2004 is ranked the highest number in publication. The journal of acupuncture & moxibustion society ranked the highest(30.8%). 2 and 4 authors ranked the highest(26.9%) in number of authors. T-test ranked the highest(58.1%) in statistics methods. P.O. med indicated in 11 articles and Pharmacopuncture in 15 articles. B16 murine melanoma cell was indicated in 25 articles by cancer-induced methods. In measurement, T cell activity was indicated in 14 articles, NK activity in 4 articles, IL-2 in 6 articles, apoptosis in 1 article, lung metastasis in 14 articles.Conclusion : Considering overall results, it is necessary to diversify cancer-induced methods and measurement methods in experimental melanoma research.

• 대한감각통합치료학회지
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• 제17권1호
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• pp.54-64
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• 2019

목적 : 다감각환경 중재에 관한 효과를 연구한 국외 논문들을 체계적으로 분석하여 임상적용 시 정보를 제공하고, 국내 다감각환경 연구에 도움이 되고자 한다. 연구방법 : 전자 데이터 베이스인 Pubmed, Cochrane, Google scholar을 이용하여 2008년부터 2018년까지의 논문을 검색하였다. 주요 검색어는 'multi-sensory environment', 'snoezelen'을 사용하였다. 최종적으로 10편의 국외논문을 선정하였으며, PICO(Patient, Intervention, Comparison, Outcome)에 따라 정리하였다. 연구결과 : 선정된 10편의 논문 중 치매환자를 대상으로 한 연구가 6편으로 가장 많았고, 그 외에 지적장애, 정신분열증, 임산부를 대상자로 하였다. 연구기간은 3주에서 10개월로, 주 2~3회기의 중재가 대부분이였고, 회기별 중재시간은 30~60분으로 나타났다. 종속변인으로는 불안과 우울과 같은 심리적인 요인과 삶의 질과 같은 사회적 요인, 인지적, 신체적인 영역에서 효과를 알아보고자 하였다. 연구에서 중재로 사용된 다감각환경은 시각, 청각, 촉각으로 구성되었으며, 그 외의 후각과 미각, 전정감각 등이 추가적으로 제공되었다. 결론 : 앞으로 국내에서는 다감각환경 중재에 대해 관심을 가지고, 다양한 대상군 특히, 아동에게 적용해 보는 연구가 이루어져야 할 것이다.

• 대한한방내과학회지
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• 제40권3호
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• pp.458-477
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• 2019

Objectives: This study aimed to investigate the trend in the research on alcoholic liver disease (ALD) using Korean traditional medicine. Methods: This review was conducted using six electronic databases (NDSL, KMBASE, Koreantk, KISS, KISTI, and KoreaMed) with no restrictions in year. The search terms were "alcoholic liver disease", "alcoholic fatty liver", "alcoholic hepatitis", "alcoholic cirrhosis", "herbal medicine", "acupuncture" and "traditional medicine". The searched studies were analyzed according to the type of research. Results: After screening, 37 studies were selected among 552. The types of studies were as follows: 8 in vivo studies, 17 case reports, 7 case series, 1 assessment scale study, 1 randomized controlled trial, and 3 research reviews. The in vivo studies reported the efficacy and its mechanism in the animal phase of single or complex herbal medicine. In the clinical research, interventions such as herbal medicine and acupuncture were most commonly used for ALD treatment. Conclusions: We analyzed the trends in ALD treatment using Korean traditional medicine through this review. The results showed that Korean traditional medicine could be an effective method for ALD treatment. Conducting related in-depth studies, such as well-designed randomized controlled trial based on the results of experimental research, is necessary.

• 대한한방내과학회지
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• 제40권1호
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• pp.13-37
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• 2019

Objectives: The purpose of this study was to assess the effects of Korean medicine for non-alcoholic fatty liver disease (NAFLD). We analyzed the result of randomized controlled trials (RCTs) that applied Korean medicine to NAFLD patients through meta analysis and systematic review. Methods: The key question was to the effects of Korean medicine for NAFLD patients according to the PICO-SD (participants, intervention, comparison, outcome, study design) and we included only RCTs. We searched 10 databases including NDSL, KMBASE, KISS, KISTI, KoreaMed, Koreantk, OASIS, Cochrane, Pubmed, EMBASE without a language restriction. We assessed risk of bias by Cochrane group's Risk of Bias tool. Results: The finally selected 12 RCTs were analyzed. Total number of participants was 1189 (male 719, female 470) as 684 and 505 in the oriental medicine group (i.e. herbal drugs, acupuncture, acupoint embedding therapy) and control group (conventional drugs, placebo), respectively. The meta analysis results of examining 7 RCTs comparing the therapeutic efficacy of herbal medicine with that of Western medicine showed statistically significant (p<0.05) differences in the efficacy evaluation, liver function test results, blood lipids, and TNF-${\alpha}$. Furthermore, the meta analysis results of investigating 3 RCTs comparing the therapeutic efficacy of herbal medicine with that of a placebo showed statistically significant (p<0.05) differences in the liver function test results, blood lipids, and waist circumference. Conclusions: The research showed that Korean medicine for NAFLD can be effective treatment. But more studies are required to enhance the level of evidence and we should report on safety.

• 대한임상독성학회지
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• 제19권1호
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• pp.1-7
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• 2021

Purpose: The purpose of this study was to conduct a systematic review to investigate the socio-economic benefits of the poison control center (PCC) and to assess whether telephone counseling at the poison control center affects the frequency of emergency room visits, hospitalization, and length of stay of patients with acute poisoning. Methods: The authors conducted a medical literature search of the PubMed, EMBASE, and Cochrane Library databases. Two reviewers evaluated the abstracts for eligibility, extracted the data, and assessed the study quality using a standardized tool. Key results such as the cost-benefit ratio, hospital stay days, unnecessary emergency room visits or hospitalizations, and reduced hospital charges were extracted from the studies. When meta-analysis was possible, it was performed using RevMan software (RevMan version 5.4). Results: Among 299 non-duplicated studies, 19 were relevant to the study questions. The cost-benefit ratios of PCC showed a wide range from 0.76 to 36 (average 6.8) according to the level of the medical expense of each country and whether the study included intentional poisoning. PCC reduced unnecessary visits to healthcare facilities. PCC consultation shortened the length of hospital stay by 1.82 (95% CI, 1.07-2.57) days. Conclusion: The systematic review and meta-analysis support the hypothesis that the PCC operation is cost-beneficial. However, when implementing the PCC concept in Korea in the future, it is necessary to prepare an institutional framework to ensure a costeffective model.

• 한방재활의학과학회지
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• 제32권3호
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• pp.13-27
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• 2022

Objectives This study investigated the trends in domestic and international clinical research in craniosacral therapy, classified as a type of Chuna manual therapy, and suggested further directions in Korean medicine. Methods This scoping review was performed using the Arksey and O'Malley methodological framework and preferred reporting items as per the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews checklist. Eight electronic databases (PubMed, EMBASE, Cochrane Library, Koreanstudies Information Service System [KISS], KMBASE, Oriental Medicine Advanced Searching Integrated System [OASIS], Research Information Sharing Service [RISS], ScienceON) were searched to identify articles with the search terms "craniosacral therapy" and "cranial osteopathy" until December 2021. Results Forty-five studies were eligible as per our inclusion criteria. Most research studies (n=44) were conducted in the field of medicine and pharmacy, especially in rehabilitation medicine (n=16). As a result of the study design, randomized controlled trials (n=20) were the most common, and chronic pain (n=9) was the most frequently targeted disease, followed by headache (n=7). Thirty-two studies suggested interventions and 20 studies used Upledger's 10-step protocol. The average duration of craniosacral therapy was 41 min per session, administered 1.4 times per week. Outcome measurements were analyzed and categorized with the examination procedure for the patient. Conclusions This is the first scoping review of craniosacral therapy in Korea, and we believe that our findings could support its utility as Chuna. In the future, more studies should be conducted to establish the evidence of clinical efficacy of craniosacral therapy and develop standard techniques in Korean medicine.

• 한국컴퓨터정보학회논문지
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• 제27권7호
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• pp.145-152
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• 2022

뇌졸중은 균형 장애와 보행능력에도 직접적인 영향을 미친다. 본 연구는 고유수용성신경근촉진법이 뇌졸중 환자의 균형 및 보행에 미치는 영향 연구를 목적으로 한다. 따라서 뇌졸중 환자에게 고유수용성 신경근촉진법을 적용하여 균형과 보행 능력을 평가하는 모든 무작위 배정 연구를 포함하였다. 본 연구는 메타분석에서 있어서 꼭 필요한 프리즈마 가이드 라인을 준수하였다. Cochrane library, CINAHL, Pubmed에서 2021년 11월까지 발행된 연구를 포함하였고, 그 연구들은 고유수용성신경근촉진법을 적용한 무작위 배정 연구들이다. 데이터베이스에서 검색된 1091개의 논문 중 18개의 연구를 메타분석을 시행하였고, 메타분석은 R 프로젝트 4.0.2를 사용하여 시행하였다. 본 연구의 전체 효과 크기는 0.56으로 중간 정도로, 균형과 보행에 관한 척도에 대한 효과 크기도 중간정도 산출되었다. 무작위 배정 정도를 나타내는 페드로 점수는 18점 만점에서 6.63으로 비뚤림 위험이 낮은 것으로 나타났다. 이러한 결과는 PNF가 뇌졸중 환자의 균형 및 보행을 향상시키는 효과적인 중재 방법임을 알 수 있다.