• 제목/요약/키워드: KoreaMed

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월경전증후군에 대한 한약 치료의 효과 : 체계적 문헌 고찰과 메타 분석 (Herbal Medicine for Premenstrual Syndrome: A Systematic Review and Meta-analysis)

  • 서지인;이윤재;고서림;김누리;김정훈;손미주;김영은;김안나;이은희
    • 대한한방부인과학회지
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    • 제36권4호
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    • pp.96-120
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    • 2023
  • Objectives: This study reports the findings that support the efficacy of herbal medicine (HM) for premenstrual syndrome (PMS). Methods: We conducted meta-analysis of findings from randomized controlled trials (RCTs) for PMS treated with HM. The articles were published before July 2022, located using 9 databases (Pubmed, EMBASE, Cochrane Library, CINAHL, CNKI, CiNii, SCIENCE ON, KoreaMed, OASIS). Results: We observed 2,034 studies, of which 23 RCTs met our inclusion criteria. The risk of bias in the included studies was relatively unclear or high. Meta-analysis of 3 RCTs showed that HM group had a significantly higher total effective rate than the western medicine group (RR 1.20 [95% CI 1.06, 1.36, p=0.004]). Meta-analysis of 1 RCT showed that HM group had a significantly lower symptom score (MD -3.04 [95% CI -5.36, -0.72, p=0.01]), while there was no significant difference in daily record of severity of problems scale (MD -20.52 [95% CI -49.33, 8.29, p=0.16]). Conclusions: HM significantly improved PMS symptoms than general treatment and no serious adverse events were reported. However, the evidence on the effectiveness and safety of HM for PMS was not enough to provide reliable results due to the small number and low quality of included studies. We believe that rigorous RCTs will lead to more reliable evidence of the intervention.

산조인탕치료가 여성갱년기 수면장애에 미치는 효과 : 체계적 문헌고찰 및 메타분석 (Sanjoin-tang (Suanzaoren decoction) for Insomnia in Menopausal Syndromes: A Systematic Review and Meta-analysis)

  • 전지희;최태영;이명수;송은혜;;박선주
    • 대한예방한의학회지
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    • 제24권1호
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    • pp.1-14
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    • 2020
  • Objectives : The purpose of this systematic review was to investigate the efficacy and safety of Sanjoin-tang (Suanzaoren decoction, SZRD) for insomnia in menopausal syndromes. Method : We searched the following databases: PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Science and Technique Journals Database (VIP), Wanfang, Research Information Service System (RISS), OASIS, Korean studies Information Service System (KISS), and National Digital Science Library (NDSL) databases. Randomized controlled trials (RCTs) or quasi-RCTs that used SZRD for women in menopause were included. The methodological quality of each RCT was assessed using the risk of bias tool. Results : In total, nine RCTs were finally included. The included RCTs had a high risk of bias across their domains. Three RCTs examined the effects of SZRD compared with western medicine (WM) in insomnia. Three RCTs showed favorable effects of SZRD with insomnia. Infrastructure also showed that SZRD resulted in better clinical WM (RR 1.19, 95% CI 1.07 to 1.32, P=0.001, I2=0%). Four RCTs showed favorable effects of Modified SZRD with insomnia. Infrastructure also showed that Modified SZRD resulted in better clinical WM (RR 1.13, 95% CI 1.04 to 1.23, P=0.004, I2=0%). Among the 4 RCTs, three RCTs showed an equivalent effect on the total Pittsburh Sleep Quality Index (PSQI). The meta-analysis also showed that Modified SZRD had a superior effect on the total of PSQI (total of PSQI : MD -2.55, 95% CI -3.72 to -1.37, P<0.0001, I2=85%). Only 2 trials reported adverse events and none reported severe adverse events. Conclusion : SZRD appears to be safe, but there is insufficient evidence to make a definitive conclusion because only a few studies reported adverse events. Due to the poor methodological quality of the included studies and the small number of trials included, the evidence cannot be reproduced and assessed. Well-designed RCTs with a larger sample size are needed in the future.

컴퓨터보조 기반 점막지지 서지컬템프레이트를 이용한 하악전치부 임플란트 식립 (Implant Fixture Installation in the Anterior Mandible by Use of a Mucosa Supported Surgical Template Based on Computer Assisted Treatment Planning)

  • 이지호;김성민;김명주;박정민;서미현;명훈;이종호;김명진
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제33권2호
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    • pp.158-165
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    • 2011
  • A 73-year-old Korean female patient with a fully edentulous mandible was planned to have five implant fixtures installed in the anterior mandible for the fixed prosthesis. After 3-dimensional (3D) computed tomographic scanning was transferred to OnDemand3D$^{(R)}$ (Cybermed Co., Seoul, Korea) software program for the virtual planning, five fixtures of MK III Groovy RP implants of Branemark System$^{(R)}$ (Nobel Biocare AB Co., Goteborg, Sweden) were installed in the anterior mandible between both mental foramens using In2Guide$^{(R)}$ (CyberMed Co., Seoul, Korea) mucosa-supported surgical template with Quick Guide Kit$^{(R)}$ (Osstem Implant Co., Seoul, Korea) systems. Fixture installations were completed successfully without any complications, such as mental nerve injury, bony bleedings, fenestrations and other unexpected events. Postoperative computed tomographic scans were aligned and fused to the planned implant, then angular and linear deviations were compared with the planned virtual implants. The mean angular deviation between the planned and actual implant axes was $3.42{\pm}1.336^{\circ}$. The mean distance between the planned and actual implant at the neck area was $0.544{\pm}0.290$ mm horizontally and $0.118{\pm}0.079$ mm vertically. The average distance between the planned and actual implant at the apex area was $1.166{\pm}0.566$ mm horizontally and $0.14{\pm}0.091$ mm vertically. These results could be considered more precise and accurate than previous reports, and even our recent results. The entire procedures of this case are reported and reviewed.

Effects of applying nerve blocks to prevent postherpetic neuralgia in patients with acute herpes zoster: a systematic review and meta-analysis

  • Kim, Hyun Jung;Ahn, Hyeong Sik;Lee, Jae Young;Choi, Seong Soo;Cheong, Yu Seon;Kwon, Koo;Yoon, Syn Hae;Leem, Jeong Gill
    • The Korean Journal of Pain
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    • 제30권1호
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    • pp.3-17
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    • 2017
  • Background: Postherpetic neuralgia (PHN) is a common and painful complication of acute herpes zoster. In some cases, it is refractory to medical treatment. Preventing its occurrence is an important issue. We hypothesized that applying nerve blocks during the acute phase of herpes zoster could reduce PHN incidence by attenuating central sensitization and minimizing nerve damage and the anti-inflammatory effects of local anesthetics and steroids. Methods: This systematic review and meta-analysis evaluates the efficacy of using nerve blocks to prevent PHN. We searched the MEDLINE, EMBASE, Cochrane Library, ClinicalTrials.gov and KoreaMed databases without language restrictions on April, 30 2014. We included all randomized controlled trials performed within 3 weeks after the onset of herpes zoster in order to compare nerve blocks vs active placebo and standard therapy. Results: Nine trials were included in this systematic review and meta-analysis. Nerve blocks reduced the duration of herpes zoster-related pain and PHN incidence of at 3, 6, and 12 months after final intervention. Stellate ganglion block and single epidural injection did not achieve positive outcomes, but administering paravertebral blockage and continuous/repeated epidural blocks reduced PHN incidence at 3 months. None of the included trials reported clinically meaningful serious adverse events. Conclusions: Applying nerve blocks during the acute phase of the herpes zoster shortens the duration of zoster-related pain, and somatic blocks (including paravertebral and repeated/continuous epidural blocks) are recommended to prevent PHN. In future studies, consensus-based PHN definitions, clinical cutoff points that define successful treatment outcomes and standardized outcome-assessment tools will be needed.

자녀양육에 대한 국내 간호학분야 연구논문 분석 (An Analysis of Nursing Research on Child Rearing in Korea)

  • 이동원;권인수
    • Child Health Nursing Research
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    • 제20권4호
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    • pp.264-274
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    • 2014
  • 목적 본 연구의 목적은 국내 간호학분야에서 수행된 양육에 대한 연구논문을 양육의 속성과 지식체 유형을 중심으로 분석하여 추후 자녀양육에 대한 연구와 간호실무의 방향을 설정하는 근거자료를 제시하는 것이다. 방법 KoreaMed, 한국학술정보, 과학기술정보통합서비스, 과학기술학회 마을, 한국교욱학술정보원의 5개 온라인 사이트를 통해 201편의 논문을 선정하였고, 개념을 양육의 속성과 지식체 유형별(기술적, 설명적, 처방적 지식)로 분석하였다. 결과 연구설계는 실험연구가 27.3%, 비실험연구가 72.7%였고, 연구대상자는 양육자로는 어머니가 가장 많았고(36.0%), 피양육자로는 신생아가 가장 많았다(29.6%). 양육속성별로는 양육에 대한 반응 영역이 가장 많았고(49.9%), 양육지식 영역이 가장 적었다(2.2%). 양육속성의 하위영역별로는 양육에 대한 반응 영역에서는 양육스트레스, 양육자신감/효능감 양육태도 등의 순이었고, 양육실제 영역에서는 애착, 부모-자녀 상호작용, 양육행동/양육실천 등의 순으로 나타났다. 아동의 성장/발달/행동 영역에서는 영아의 성장과 발달, 행동/건강 문제 등의 순으로 나타났다. 지식체 유형별로는 설명적 지식이 가장 많았고(55.2%), 처방적 지식(30.0%), 기술적 지식(14.9%)의 순으로 나타났다. 결론 자녀양육과 관련하여 다양한 지식체가 개발되었으나 처방적 지식의 개발이 미흡하며, 발달단계별 양육과 어머니 외의 다른 양육자 대상 연구가 부족하였고, 양육의 실제적인 측면보다는 양육에 대한 반응에 관한 연구가 더 많았다. 따라서 양육의 공동 책임자인 아버지와 대리 양육자 대상의 연구, 아동의 발달 단계별 건강을 위한 아동간호학의 차별화된 지식 개발 연구, 양육실제를 유도하는 처방적 지식을 개발하는 연구와 아동양육의 국가적 중요성을 감안하여 아동양육정책 개발 연구를 제언한다.

만성 족관절 불안정증에서 건이식을 이용한 외측 인대 재건술의 적응증 (The Indication of Ankle Lateral Ligament Reconstruction Using Tendon Graft in Chronic Ankle Instability)

  • 박재용;최기원;조재호;강찬;최경진;정진화;김학준;배서영;차승도;김기천;한승환;2015 대한족부족관절학회 보험장애판정위원회
    • 대한족부족관절학회지
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    • 제20권1호
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    • pp.12-18
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    • 2016
  • Purpose: The purpose of this study is to review the indications of ankle lateral complex reconstruction using tendon graft. Materials and Methods: We searched PubMed using the index, "ankle, instability, lateral ligament, reconstruction" from 1990 to present (September 30, 2015). We excluded 1) modified Brőstrom operation (MBO), 2) conventional tenodesis surgery, 3) review article, 4) technical note, and 5) articles written in another foreign language. We reviewed 24 papers through the publication events, operational method, the indications of surgery, and the specific features of the patient group. Results: There were the indications of 1) previous ligament surgery failure, 2) situation when ligament repair is impossible due to the ligament defect, 3) severe instability (preoperative talar tilt >$15^{\circ}$, anterior draw >10 mm or the difference of contralateral side talar tilt >$5^{\circ}$, anterior draw >3 mm), and 4) overweight (body mass index >$30kg/m^2$). Other considerations included 1) generalized joint laxity and 2) workers, highly-demanded or athlete highly-affected by instability. Conclusion: The ankle lateral complex reconstruction using tendon graft could be indicated in patients with the possibility of MBO failure with several considerations.

마스크의 인증기준 비교와 바이러스 여과효율에 대한 고찰 (Comparisons of Certification Standards for Mask and Review on Filtration Efficiency for Viruses)

  • 윤충식;고슬비;박지훈
    • 한국산업보건학회지
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    • 제30권2호
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    • pp.109-123
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    • 2020
  • Objectives: The aims of this study were to review the standards and key components of the standards for disposable masks in Korea, the US, EU, Japan, and China and to evaluate the appropriateness of disposable masks during a virus pandemic. Methods: We reviewed the standards in the above countries and compared their key elements for each standard. For the second purpose, systemic paper gathering using key words like 'mask', 'respirator' 'virus', and 'coronavirus' in the PubMed search engine was performed. Fifty-three papers were selected and reviewed in regard to the appropriateness of test protocols with sodium chloride(NaCl) particles for virus filtration and the effectiveness against viruses. Results: The standards for masks are largely divided into two categories: US standards and EU standards. In Korea, the Ministry of Employment and Labor adapted the EU standards for workers and the Health Masks adopted the Ministry of Employment and Labor standards by the Ministry of Food and Drug Safety. Regarding airborne viral infections, WHO emphasizes only droplet infection, while many studies have shown that small particles enter the air through coughing or sneezing, which increases the possibility of airborne infection. Compared to other particles, various factors such as airborne viability and the ability to replicate the virus in the body are further involved in the virus's airborne infection rate. Airborne infection is classified into absolute air infection, preferential air infection, and opportunistic air infection. The NaCl-certified N95 mask showed good filtration efficiency against viruses and NaCl particles were proved to be a surrogate material for viruses. From this, KF94 is also expected to be effective in blocking viruses. Conclusion: The N95 test method could be used as a surrogate test method for virus filtration. N95-class masks have been found to effectively block viral infections in the air. However, surgical or medical masks are only partially effective against airborne virus infection though they could effectively block large droplet infection. However, most studies considered in this study targeted N95 in foreign countries and studies on masks actually used in Korea are very limited, so studies on microorganisms and reuse on domestic masks should be conducted in the future.

노인 운전자에게 적용한 컴퓨터 기반 운전중재 프로그램에 관한 체계적 고찰 (A Systematic Study of Computer-Based Driving Intervention Program for Elderly Drivers)

  • 김덕주
    • 한국산학기술학회논문지
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    • 제20권4호
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    • pp.293-302
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    • 2019
  • 본 연구는 노인 운전자를 대상으로 한 컴퓨터 기반 운전중재 프로그램에 대해 체계적으로 분석함으로써, 노인을 위한 운전중재에 대한 근거를 제시하고자 하였다. 연구 분석을 위해 2009년 1월부터 2018년 10월까지 출판된 문헌들을 대상으로 하였으며, 국외 문헌은 'Pubmed, Goggle Scholar, Science Direct'에서 검색하였고, 국내 문헌은 'RISS, Keris, KISS'를 통하여 검색하였다. 총 359편의 논문이 검색되었고, 포함기준과 배제기준을 바탕으로 분석하여 최종 10편의 논문이 분석에 사용되었으며, 근거수준 I이 8편(80%), III가 2편(20%)이었다. 분석결과 노인에게 적용한 컴퓨터 기반 중재 방법에는 운전 시뮬레이터가 7편(70%)으로 가장 많았으며, 비디오 영상훈련 2편(20%), 닌텐도 Wii 프로그램이 1편(10%)을 차지하였다. 대부분의 연구에서 운전 시뮬레이터는 노인들의 인지영역과 시지각 능력을 훈련하고, 다양한 모의 상황에서 위험 상황에 대처하는 능력을 향상시켜 주었으며, 다른 중재방법들도 노인들에게 긍정적인 영향을 미쳤다. 노인 운전자를 평가한 평가 항목에서는 운전 시뮬레이터를 사용한 운전수행능력 평가가 가장 많았으며, 그 외 주의력, 시공간 능력, 인지기능, 위험인지 평가, 우울 및 불안평가 등이 시행되었다. 노인 운전자를 대상으로 한 컴퓨터 기반 운전중재 프로그램은 다양한 영역들을 훈련하고 평가하기에 적절하며, 안전운전을 위한 중재도구로 효과적으로 활용될 수 있을 것으로 기대한다.

작업장 화학물질 독성예측을 위한 독성발현경로의 응용과 전망 (Adverse Outcome Pathways for Prediction of Chemical Toxicity at Work: Their Applications and Prospects)

  • 임경택;최흥구;이인섭
    • 한국산업보건학회지
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    • 제29권2호
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    • pp.141-158
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    • 2019
  • Objectives: An adverse outcome pathway is a biological pathway that disturbs homeostasis and causes toxicity. It is a conceptual framework for organizing existing biological knowledge and consists of the molecular initiating event, key event, and adverse output. The AOP concept provides intuitive risk identification that can be helpful in evaluating the carcinogenicity of chemicals and in the prevention of cancer through the assessment of chemical carcinogenicity predictions. Methods: We reviewed various papers and books related to the application of AOPs for the prevention of occupational cancer. We mainly used the internet to search for the necessary research data and information, such as via Google scholar(http://scholar.google.com), ScienceDirect(www.sciencedirect.com), Scopus(www.scopus. com), NDSL(http: //www.ndsl.kr/index.do) and PubMed(http://www.ncbi.nlm.nih.gov/pubmed). The key terms searched were "adverse outcome pathway," "toxicology," "risk assessment," "human exposure," "worker," "nanoparticle," "applications," and "occupational safety and health," among others. Results: Since it focused on the current state of AOP for the prediction of toxicity from chemical exposure at work and prospects for industrial health in the context of the AOP concept, respiratory and nanomaterial hazard assessments. AOP provides an intuitive understanding of the toxicity of chemicals as a conceptual means, and it works toward accurately predicting chemical toxicity. The AOP technique has emerged as a future-oriented alternative to the existing paradigm of chemical hazard and risk assessment. AOP can be applied to the assessment of chemical carcinogenicity along with efforts to understand the effects of chronic toxic chemicals in workplaces. Based on these predictive tools, it could be possible to bring about a breakthrough in the prevention of occupational and environmental cancer. Conclusions: The AOP tool has emerged as a future-oriented alternative to the existing paradigm of chemical hazard and risk assessment and has been widely used in the field of chemical risk assessment and the evaluation of carcinogenicity at work. It will be a useful tool for prediction, and it is possible that it can help bring about a breakthrough in the prevention of occupational and environmental cancer.

직업성 극저주파 자기장 노출평가와 노출 기준에 대한 쟁점 고찰 (Brief Review on Exposure Characteristics, Monitoring Instruments and Threshold Limit Values for Extremely Low Frequency-Magnetic Field (ELF-MF))

  • 박동욱;이승희;조경이
    • 한국산업보건학회지
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    • 제32권4호
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    • pp.381-392
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    • 2022
  • Objectives: Objective of this study is to review briefly exposure characteristics, monitoring instruments and threshold limit values for extremely low frequency-magnetic field (ELF-MF) methods. This study was undertaken through brief literature review. We performed a literature search in PubMed to identify ELF-MF studies conducted in workplaces. Initial search keywords such as 'extremely low frequency-magnetic field (ELF-MF)' and 'electromagnetic fields (EMF)' combined or singly. We limited our review to occupational rather than general nonworkplace environmental exposures. Methods: The contents we reviewed: key industry and occupations generating ELF-MF, several direct-reading instruments monitoring ELF-MF and threshold limit values (TLV) preventing health effects may be caused by the exposure to ELF-MF. Results: The industries related to the generation and supply of electricity, electrolytic installations, welding, and induction heating and more were regarded as high ELF-MF exposure industries. All jobs handling or employed performed in power cable lines, electrical wiring, and electrical equipment are found to be exposed to ELF-MF. Threshold or ceiling limit, 1,000 µT, is established to prevent acute effects of exposure to low-frequency EMFs on the nervous system: the direct stimulation of nerve and muscle tissues and the induction of retinal phosphenes. The International Agency for Research on Cancer (IARC) has classified ELF-MF as possibly carcinogenic to humans chiefly based on epidemiological studies on childhood leukemia. However, a causal relationship between magnetic fields and several types of cancer including childhood leukemia has not been established nor has any other long-term effects. Risk management using precautionary measures, has been initiated by the US and EU to prevent chronic health effects related to ELF-MF exposure in workplaces. Conclusion: This study recommends the implementation of various measures such as theestablishment of occupational exposure limit values for ELF-MF and precautionary principle to prevent potential chronic occupational health effects may be caused by ELF-MF in Korea.