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Meta-analysis for Efficacy and Safety of Propofol during Dental Sedation

  • Choi, Seong-Seok;Seo, Kwang-Suk;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.2
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    • pp.75-91
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    • 2012
  • Background: Dental sedation reduces fear and phobia during dental treatment and helps patients get quality treatment by inducing adequate consciousness control. Propofol has recently grabbed the spotlight, but no meta-analysis for efficacy and safety of propofol in dentistry has yet been performed. Thus, the purpose of this study was to perform meta-analysis to verify the efficacy and safety of propofol for use in dental sedation. Methods: Articles published between 1980 and 2010 were searched in the web sites, journals and medical database including The Cochrane Library, MEDLINE and EMBASE. And a total of 22 studies were selected among the randomized controlled trials (RCTs) that compared the use of propofol with other sedatives (control group). The data was collected from these studies and meta-analysis for efficacy and safety was performed using Comprehensive Meta-Analysis 5.0 (CMA 5.0). Results: The patient recovered significantly faster and discharged significantly earlier in the propofol group (SMD = -1.442, P < 0.001). The satisfaction of patient and that of operator was higher in the propofol group (P < 0.05). The incidence of arrhythmia and apnea/ hypoventilation was significantly lower in the propofol group (OR = 0.071, P < 0.05), and there was no significant difference in the other side effects. On the level of sedation, although the sedation score was significantly lower in the propofol group (SMD = -0.430, P < 0.05). Conclusions: The present analysis showed that the use of propofol resulted in high satisfaction levels on the part of the patients and operators, a shorter recovery time, and faster hospital discharge. The incidence of complications, however, was lower in the propofol groups or not much different between the propofol and control groups. Thus, the adequate use of propofol in dentistry is believed to be helpful for the effective and safe sedation of the patients.

Effectiveness of Arch Support Taping is Subjects With Excessive Foot Pronation: A Meta-analysis

  • Park, So-yeon
    • Physical Therapy Korea
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    • v.26 no.4
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    • pp.70-76
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    • 2019
  • Background: An excessive pronated foot is defined as a flattening or complete loss of the medial longitudinal arch. Excessive foot pronation is considered to have high risk factors of overuse injuries in the lower limb. Various treatments have been investigated in attempts to control excessive pronation. Objects: This meta-analysis identifies the effects of an anti-pronation taping technique using different materials. Methods: The electronic databases used include MEDLINE, the Physiotherapy Evidence Database (PEDro), Science Direct, the Korean Studies Information Service System (KISS), the Research Information Sharing Service (RISS), the Korea National Library, and the Korean Medical Database (studies published up to July 31, 2019). The database search used the following keywords: "foot drop" OR "foot arch" OR "foot pronation" OR "flat foot (pes planus)" AND "taping" OR "support." Eight eligible studies were analyzed to determine the effectiveness of anti-pronation taping in study and control groups. Results: The overall random effect size (Hedges'g) of the anti-pronation taping technique was 0.147 (95% confidence interval [CI]: -.214 to .509). When the effect (Hedges' g) was compared by the type of tape material, rigid tape (RT; Lowdye taping) was .213 (95% CI: -.278 to .704) and kinesiotape (KT; arch support taping) was -.014 (95% CI: -.270 to .242). Based on this meta-analysis, it was not possible to identify the extent to which anti-pronation taping was effective in preventing navicular drop, improving balance, or changing foot pressure. Only three of the eight eligible studies applied KT on excessive pronated feet, and the outcome measure areas were different to those of the RT studies. The KT studies used EMG data, overall foot posture index (FPI) scores, and rear foot FPI scores. In contrast, the RT studies measured navicular heights, various foot angles, and foot pressure. Conclusion: This review could not find any conclusive evidence about the effectiveness of any taping method for patients with pronated feet. Future studies are needed to develop the anti-pronation taping technique based on the clinical scientific evidence.

Review for Clinical Studies of Oriental Medicine on the Prevention of Ovarian Hyperstimulation Syndrome (난소과자극증후군의 예방에 관한 한의 임상 연구 고찰)

  • Ku, Su-Jeong;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock
    • The Journal of Korean Obstetrics and Gynecology
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    • v.33 no.1
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    • pp.1-18
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    • 2020
  • Objectives: This review is aimed at assessing the efficacy and effectiveness of oriental medicine for the prevention of Ovarian Hyperstimulation Syndrome (OHSS) through literature research and overview. Methods: Database searching was conducted to identify relevant randomized controlled trials (RCTs) on oriental medicine for the prevention of Ovarian Hyperstimulation Syndrome. Studies were searched from Journal of Korean Obstetrics and Gynecology, Korean studies Information Service System, Korean Medical Database, China National Knowledge Infrastructure, Cochrane library, PubMed and EmBase up to 7th November, 2019. Results: Ten RCTs were finally selected. Eight studies intervened with oral Chinese herb medicine, one is intervened with Chinese medicine enema and the other with acupuncture. Eight studies concluded that intervention with oriental medicine significantly decreased OHSS incidence. Five studies showed significantly higher pregnancy rate in the intervention groups. Two studies reported higher ovulation rate and other two studies showed more maturated eggs than the control groups. Four studies showed opposite results in serum Estradiol level. Vascular Endothelial Growth Factor level was significantly lower in the intervention groups in two studies. Conclusions: From ten studies, oriental medicine reduced OHSS incidence rate and showed preventable effectiveness. Further strictly designed studies and acupuncture intervened studies are needed to establish evidences.

A Review of Studies Using Syndrome Differentiation Questionnaire in Cancer Patients (암 환자 대상 변증 설문지 활용 현황에 대한 문헌고찰)

  • Park, Su Bin;Yoon, Jee-Hyun;Kim, Eun Hye;Lee, Jee Young;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.26 no.1
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    • pp.1-15
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    • 2021
  • Objective: The aim of this review is to analyze the studies using syndrome differentiation questionnaire in cancer patients. Methods: We searched electronic databases including Pubmed, google scholar, Cochrane library, CNKI, KISS, RISS and OASIS. Key words used for searching were cancer, Korean medicine, pattern identification, and questionnaire. Studies using a symptom differentiation questionnaire to cancer patients were selected. Results: 35 studies were enrolled. A total of 17 questionnaires was used. Most of the types of included studies were observational studies, followed by randomized controlled trials (RCTs) and validation studies. The purposes of using questionnaires were rrelation analysis, outcome measurement, evaluating adverse events, subgroup analysis, and questionnaire development. The most used questionnaire was Body Constitution Questionnaire (BCQ), and it was used 8 times, Questionnaire for the Sasang Constitution Classification II (QSCC II) was used 5 times, Constitution in Chinese Medicine Questionnaire (CCMQ), TCM-Symptom Complex Differentiation Questionnaire (TCM-SCDQ), Yin Deficiency Questionnaire were used 4 times, and Qi Blood Yin Yang Deficiency Questionnaire was used twice. BCQ is a questionnaire diagnosing and evaluating yang deficiency, yin deficiency, and blood stasis. It has high reliability, validity, and optimal cut-off value. Conclusion: BCQ is the most used syndrome differentiation questionnaire in cancer-related studies. So, BCQ could be recommended in syndrome differentiation-related cancer studies.

Comparative Efficacy and Safety of Long-acting Injectable and Oral Second-generation Antipsychotics for the Treatment of Schizophrenia: A Systematic Review and Meta-analysis

  • Park, Seon-Cheol;Choi, Mi Young;Choi, Jina;Park, Eunjung;Tchoe, Ha Jin;Suh, Jae Kyung;Kim, Young Hoon;Won, Seung Hee;Chung, Young-Chul;Bae, Kyung-Yeol;Lee, Sang-Kyu;Park, Chan Mi;Lee, Seung-Hwan
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.361-375
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    • 2018
  • We aimed to compare the efficacy and safety of long-acting injectable (LAI) and oral second-generation antipsychotics (SGAs) in treating schizophrenia by performing a systematic review and meta-analysis. MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Library, as well as five Korean databases, were systemically searched to identify studies published from 2000 to 16 April 2015, which compared the efficacy and safety of LAI and oral SGAs. Using data from randomized controlled trials (RCTs), meta-analyses were conducted. In addition, the GRADE (the Grading of Recommendations, Assessment, Development and Evaluation) approach was applied to explicitly assess the quality of the evidence. A total of 30 studies including 17 RCTs and 13 observational studies were selected. The group treated with LAI SGAs was characterized by significantly lower relapse rates, longer times to relapse and fewer hospital days, but also by a higher occurrence of extrapyramidal syndrome and prolactin-related symptoms than that in the group treated with oral SGAs. Our findings demonstrate that there is moderate to high level of evidence suggesting that in the treatment of schizophrenia, LAI SGAs have higher efficacy and are associated with higher rates of extrapyramidal syndrome and prolactin-related symptoms. Additionally, the use of LAI SGAs should be combined with appropriate measures to reduce dopamine $D_2$ antagonism-related symptoms.

Clinical Effectiveness of Acupuncture in the Treatment of Non-Alcoholic Fatty Liver Disease: A Systematic Review (비알코올성 지방간 질환에 대한 침치료의 효과 : 체계적 고찰)

  • Hyun, Joon;Lee, Joo-bok;Kim, So-yeon;Han, Chang-woo
    • The Journal of Internal Korean Medicine
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    • v.39 no.6
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    • pp.1206-1224
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    • 2018
  • Purpose: This systematic review was planned and performed in order to determine the clinical effectiveness of acupuncture for non-alcoholic fatty liver disease (NAFLD). Methods: We searched related randomized controlled trials in several medical online databases, including China National Knowledge Infrastructure (CNKI), Excerpta Medica dataBASE (EMBASE), Public/Publisher MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), National Digital Science Library (NDSL), and Research Information Sharing Service (RISS). NAFLD related outcomes were extracted from the included trials and meta-analyzed. Results: From the 8 included trials, the values of the following examinations were extracted: liver ultrasonography, liver CT, body fat CT, aspartate transaminase (AST), alanine transaminase (ALT), gamma-glutamyltransferase (GGT), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, fasting blood sugar (FBS), hosmeostatic model assessment for insulin resistance (HOMA-IR), weight, body mass index (BMI), waist hip ratio (WHR), obesity degree, body fat mass, body fat rate, leptin, malondialdehyde (MDA), and super oxide dismutase (SOD). In the 4 outcomes, cure rate in liver ultrasonography (RR=1.56; 95%CI=1.05~2.31; P=0.03), cure rate in liver CT (RR=2.23; 95%CI=1.33~3.72; P=0.002), TC (MD=-0.78; 95%CI=-1.41~-0.15; P=0.02), and TG (MD=-2.05; 95%CI=-3.88~-0.21; P=0.03), acupuncture was more effective than the control intervention. Conclusions: In this meta-analysis, acupuncture relieved hepatic steatosis, and reduced TC, and TG in NAFLD patients. more well-planned studies are still needed due to the heterogeneity and the considerable methodological flaws in the analyzed trials.

Pharmacological Treatment of Major Depressive Episodes with Mixed Features: A Systematic Review

  • Shim, In Hee;Bahk, Won-Myong;Woo, Young Sup;Yoon, Bo-Hyun
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.376-382
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    • 2018
  • We reviewed clinical studies investigating the pharmacological treatment of major depressive episodes (MDEs) with mixed features diagnosed according to the dimensional criteria (more than two or three [hypo]manic symptoms+principle depressive symptoms). We systematically reviewed published randomized controlled trials on the pharmacological treatment of MDEs with mixed features associated with mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD). We searched the PubMed, Cochrane Library, and ClinicalTrials.gov databases through December 2017 with the following key word combinations linked with the word OR: (a) mixed or mixed state, mixed features, DMX, mixed depression; (b) depressive, major depressive, MDE, MDD, bipolar, bipolar depression; and (c) antidepressant, antipsychotic, mood stabilizer, anticonvulsant, treatment, medication, algorithm, guideline, pharmacological. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We found few randomized trials on pharmacological treatments for MDEs with mixed features. Of the 36 articles assessed for eligibility, 11 investigated MDEs with mixed features in mood disorders: six assessed the efficacy of antipsychotic drugs (lurasidone and ziprasidone) in the acute phase of MDD with mixed features, although four of these were post hoc analyses based on large randomized controlled trials. Four studies compared antipsychotic drugs (olanzapine, lurasidone, and ziprasidone) with placebo, and one study assessed the efficacy of combination therapy (olanzapine+fluoxetine) in the acute phase of BD with mixed features. Pharmacological treatments for MDEs with mixed features have focused on antipsychotics, although evidence of their efficacy is lacking. Additional well-designed clinical trials are needed.

A feasibility study on photo-production of 99mTc with the nuclear resonance fluorescence

  • Ju, Kwangho;Lee, Jiyoung;ur Rehman, Haseeb;Kim, Yonghee
    • Nuclear Engineering and Technology
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    • v.51 no.1
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    • pp.176-189
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    • 2019
  • This paper presents a feasibility study for producing the medical isotope $^{99m}Tc$ using the hazardous and currently wasted radioisotope $^{99}Tc$. This can be achieved with the nuclear resonance fluorescence (NRF) phenomenon, which has recently been made applicable due to high-intensity laser Compton scattering (LCS) photons. In this work, 21 NRF energy states of $^{99}Tc$ have been identified as potential contributors to the photo-production of $^{99m}Tc$ and their NRF cross-sections are evaluated by using the single particle estimate model and the ENSDF data library. The evaluated cross sections are scaled using known measurement data for improved accuracy. The maximum LCS photon energy is adjusted in a way to cover all the significant excited states that may contribute to $^{99m}Tc$ generation. An energy recovery LINAC system is considered as the LCS photon source and the LCS gamma spectrum is optimized by adjusting the electron energy to maximize $^{99m}Tc$ photo-production. The NRF reaction rate for $^{99m}Tc$ is first optimized without considering the photon attenuations such as photo-atomic interactions and self-shielding due to the NRF resonance itself. The change in energy spectrum and intensity due to the photo-atomic reactions has been quantified using the MCNP6 code and then the NRF self-shielding effect was considered to obtain the spectrums that include all the attenuation factors. Simulations show that when a $^{99}Tc$ target is irradiated at an intensity of the order $10^{17}{\gamma}/s$ for 30 h, 2.01 Ci of $^{99m}Tc$ can be produced.

Diagnostic value of magnetic resonance imaging using superparamagnetic iron oxide for axillary node metastasis in patients with breast cancer: a meta-analysis

  • Lee, Ru Da;Park, Jung Gu;Ryu, Dong Won;Kim, Yoon Seok
    • Kosin Medical Journal
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    • v.33 no.3
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    • pp.297-306
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    • 2018
  • Objectives: Identification of axillary metastases in breast cancer is important for staging disease and planning treatment, but current techniques are associated with a number of adverse events. This report evaluates the diagnostic accuracy of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) techniques for identification of axillary metastases in breast cancer patients. Methods: We performed a meta-analysis of previous studies that compared SPIO enhanced MRI with histological diagnosis after surgery or biopsy. We searched PubMed, Ovid, Springer Link, and Cochrane library to identify studies reporting data for SPIO enhanced MRI for detection of axillary lymph node metastases in breast cancer until December 2013. The following keywords were used: "magnetic resonance imaging AND axilla" and "superparamagnetic iron oxide AND axilla". Eligible studies were those that compared SPIO enhanced MRI with histological diagnosis. Sensitivity and specificity were calculated for every study; summary receiver operating characteristic and subgroup analyses were done. Study quality and heterogeneity were also assessed. Results: There were 7 publications that met the criteria for inclusion in our meta-analysis. SROC curve analysis for per patient data showed an overall sensitivity of 0.83 (95% Confidence interval (CI): 0.75-0.89) and overall specificity of 0.97 (95% CI: 0.94-0.98). Overall weighted area under the curve was 0.9563. Conclusions: SPIO enhanced MRI showed a trend toward high diagnostic accuracy in detection of lymph node metastases for breast cancer. So, when the breast cancer patients has axillary metastases histologically, SPIO enhanced MRI may be effective diagnostic imaging modality for axillary metastases.

Books Related to Acupuncture Published in North Korea (북한의 침구학 서적에 대한 개괄적 연구)

  • Kim, Jong-hyun;Kim, Song-Yi
    • Korean Journal of Acupuncture
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    • v.37 no.4
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    • pp.231-244
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    • 2020
  • Objectives : This study was conducted to introduce the types and contents of books related to acupuncture published in North Korea that can be identified in South Korea, and to understand the general characteristics of North Korean acupuncture. Methods : Firstly, we identified books related to acupuncture in the Information Center on North Korea of the National Library of Korea. Specialized books on treatment interventions such as acupuncture, moxibustion, cupping, electrotherapy, and manual therapy including acupressure which stimulate acupoints were included in the study. Two authors reviewed the title, table of contents, and contents of each book in the order of publication year for the searched books. Based on this, the characteristics and trends of North Korean acupuncture were comprehensively examined. Results : The included 18 books were published between 1964 and 2018. One of them was considered a Chinese book translated into Korean and published in China, and another was a North Korean book republished by a South Korean publisher. Except for these, all were published in North Korea, two of which were translations of Chinese books. Most of them were books on the theory and clinical applications of acupuncture, but some of them focused on specific treatment interventions such as auricular acupuncture, fire needling, manual therapy, cupping, or electrotherapy. Also, there was a book about the mechanism of acupuncture analgesia in a neurophysiological way. Conclusions : Since the mid-1960s, North Korea has been steadily attempting to combine acupuncture and Western medicine by applying the disease name and classification system of Western medicine, using modern diagnostic technique, and explaining the mechanism of acupuncture based on the latest research. After the 2000s, the standard international acupuncture nomenclature by World Health Organization was used. In recent years, there has been a tendency to publish and widely disseminate specialized books on non-pharmacological treatment such as cupping, electrotherapy, and fire needling.