• Title/Summary/Keyword: QOL(Quality of life)

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A Prospective, Multi-Center, Double-Blind, Randomized Study to Evaluate the Efficacy and Safety of the Synthetic Bone Graft Material DBM Gel with rhBMP-2 versus DBM Gel Used during the TLIF Procedure in Patients with Lumbar Disc Disease

  • Hyun, Seung-Jae;Yoon, Seung Hwan;Kim, Joo Han;Oh, Jae Keun;Lee, Chang-Hyun;Shin, Jun Jae;Kang, Jiin;Ha, Yoon
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.562-574
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    • 2021
  • Objective : This study is to evaluate the efficacy and safety of demineralized bone matrix (DBM) gel versus DBM gel with recombinant human bone morphogenetic protein-2 (rhBMP-2) used in transforaminal lumbar interbody fusion (TLIF). Methods : This study was designed as a prospective, multi-center, double-blind method, randomized study. All randomized subjects underwent TLIF with DBM gel with rhBMP-2 group (40 patients) as an experimental group or DBM gel group (36 patients) as a control group. Post-operative observations were performed at 12, 24, and 48 weeks. The spinal fusion rate on computed tomography scans and X-rays films, Visual analog scale pain scores, Oswestry disability index and SF-36 quality of life (QOL) scores were used for the efficacy evaluation. The incidence rate of adverse device effects (ADEs) and serious adverse device effects (SADEs) were used for safety evaluation. Results : The spinal fusion rate at 12 weeks for the DBM gel with rhBMP-2 group was higher with 73.68% compared to 58.82% for the DBM gel group. The 24 and 48 weeks were 72.22% and 82.86% for the DBM gel with rhBMP-2 group and 78.79% and 78.13%, respectively, for the DBM gel group. However, there were no significant differences between two groups in the spinal fusion rate at 12, 24, and 48 weeks post-treatment (p=0.1817, p=0.5272, p=0.6247). There was no significant difference between the two groups in the incidence rate of ADEs (p=0.3836). For ADEs in the experimental group, 'Pyrexia' (5.00%) was the most common ADE, followed by 'Hypesthesia', 'Paresthesia', 'Transient peripheral paralysis', 'Spondylitis' and 'Insomnia' (2.50%, respectively). ADEs reported in control group included 'Pyrexia', 'Chest discomfort', 'Pain', 'Osteoarthritis', 'Nephropathy toxic', 'Neurogenic bladder', 'Liver function analyses' and 'Urticaria' (2.86%, respectively). There was no significant difference between the two groups in the incidence rate of SADEs (p=0.6594). For SADE in the experimental group, ''Pyrexia' and 'Spondylitis' were 2.50%. SADE reported in the control group included 'Chest discomfort', 'Osteoarthritis' and 'Neurogenic bladder'. All SADEs described above were resolved after medical treatment. Conclusion : This study demonstrated that the spinal fusion rates of DBM gel group and DBM gel with rhBMP-2 group were not significantly different. But, this study provides knowledge regarding the earlier postoperative effect of rhBMP-2 containing DBM gel and also supports the idea that the longer term follow-up results are essential to confirm the safety and effectiveness.

A Systematic Review of effect on Heat-sensitive Moxibustion for Benign Prostatic Hyperplasia (전립선비대증에 대한 열민구(熱敏灸)의 효과에 관한 체계적 문헌 고찰)

  • Kim, MinSeok;Ju, HongMin;Kim, MinHwa;Park, SunYoung;Yun, YoungJu;Park, SeongHa
    • The Journal of Korean Medicine
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    • v.42 no.3
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    • pp.153-164
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    • 2021
  • Objectives: The aim of this study is to investigate the effect of Heat-sensitive Moxibustion on Benign Prostatic Hyperplasia Methods: We searched articles from Academic Journals(CAJ) online databases, Oriental Medicine Advanced Searching Integrated System (OASIS), Searching key words were '前列腺增生', '熱敏灸' and '열민구', '전립선비대'. The search range included randomized controlled trials (RCTs). Among the articles published to 2020, 10 articles were found. After review the title, abstract and original, 3 articles were selected finally to rule out treatment combined with completely different treatments. Result: The Heat-sensitive moxibustion at acupoints in the treatment of Benign prostatic hyperplasia were significantly superior to control group after treatment in the symptoms of patients, IPSS, QOL, PVR and Qmax(P<0.05). The Heat-sensitive moxibustion can significantly reduce the incidence of temporary urinary incontinence after Transurethral resection of the prostate(TURP) and improve life quality and satisfaction of patients(P<0.05). The individualized desensitization saturated time and amount of Heat-sensitive moxibustion is superior effective to general amount and time of traditional moxibustion in the total effective rate, IPSS, Ru and Qmax(P<0.01) for Benign prostatic hyperplasia. Conclusion: Heat sensitive moxibustion directly transfer heat to the source of a disease. So it can be considered as a good treatment for Benign prostate hypertrophy. It was also shown a better effect on BPH compared to traditional moxibustion, According to the thermo principles of tumor, if the tumor cell's death temperature of 43℃ is reached, that can cause tumor degeneration. Therefore I think Heat sensitive moxibustion can be applied to various tumor disease. The results of this study could be applied to clinical treatment of BPH. However, additional large-scale clinical researches should be conducted.

Models for Spiritual Care in Hospice and Palliative Care

  • Kang, Kyung-Ah
    • Journal of Hospice and Palliative Care
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    • v.21 no.2
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    • pp.41-50
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    • 2018
  • Spirituality is an essential part of human beings. Spiritual care, designed to meet the spiritual needs of terminally ill patients and their families, is one of the most important aspects of hospice and palliative care (HPC). This study reviewed and analyzed literature utilizing the most commonly used Korean and international healthcare databases to identify care models that adequately address the spiritual needs of terminally ill patients and their families in practice. The results of this study show that spirituality is an intrinsic part of humans, meaning that people are holistic beings. The literature has provided ten evidence-based theories that can be used as models in HPC. Three of the models focus on how the spiritual care outcomes of viewing spiritual health, quality of life, and coping, are important outcomes. The remaining seven models focus on implementation of spiritual care. The "whole-person care model" addresses the multidisciplinary collaboration within HPC. The "existential functioning model" emphasizes the existential needs of human beings. The "open pluralism view" considers the cultural diversity and other types of diversity of care recipients. The "spiritual-relational view" and "framework of systemic organization" models focus on the relationship between hospital palliative care teams and terminally ill patients. The "principal components model" and "actioning spirituality and spiritual care in education and training model" explain the overall dynamics of the spiritual care process. Based on these models, continuous clinical research efforts are needed to establish an optimal spiritual care model for HPC.

Acute Insomnia in Post-Traffic Accident Patients Treated with M&L Psychotherapy Combined with Traditional Korean Medicine: Three Case Reports (교통사고 후 발생한 급성 수면장애 환자에 대한 M&L 심리치료와 한방 복합치료 치험 3례)

  • KANGMOO GOO;Ji-Won Park;Jeong-Hyo Ji;Na-young Kim;Dong-Hwan Lee;Hyo-Rim Kim;Yu-Ra Im;Ja-Yean Son;Seok Gyu Yang
    • Journal of Oriental Neuropsychiatry
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    • v.35 no.2
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    • pp.205-216
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    • 2024
  • Objectives: To evaluate the effectiveness of Mindfulness & Loving Beingness (M&L) psychotherapy combined with traditional Korean medicine in treating acute sleep disorders in patients hospitalized following traffic accidents. Methods: We applied traditional Korean medicine treatments in conjunction with various mindfulness meditation techniques from M&L therapy, including Resource Mindfulness and Nourishment Brief Therapy. This study was conducted on three patients who reported acute sleep disorder symptoms on the first day of hospitalization following a traffic accident. The effectiveness of these interventions was assessed using the PTSD Checklist for DSM-5 (PCL-5-K), Insomnia Severity Index (ISI), EuroQol 5-Dimension (EQ-5D), Numerical Rating Scale (NRS), and Patient Global Impression of Change (PGIC). Results: ISI and PCL-5-K scores showed significant improvements after treatment, indicating reduced sleep disturbances and stress symptoms. Additionally, EQ-5D and PGIC scores were enhanced, reflecting an overall improvement in quality of life. Conclusions: This study suggests that integrating M&L therapy with traditional Korean medicine could significantly improve symptoms in patients with acute sleep disorders following traffic accidents.

Effect of Korean Medicine Treatment Including Korean Medicine Counselling on Weight Loss in Patients with Morbid Obesity: A Retrospective Chart Review (고도비만 환자 대상 한의 비만 상담을 포함한 한의치료의 체중 감량 효과: 후향적 차트 리뷰)

  • Kim, Sungha;Han, Kyungsun;Kwon, Ojin;Lee, Wongu;Yoon, Chulsang;Lee, Jun-Hwan
    • Journal of Korean Medicine for Obesity Research
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    • v.21 no.1
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    • pp.22-31
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    • 2021
  • Objectives: We conducted a retrospective chart review to investigate the effects of Korean Medicine (KM) treatment on weight loss in patients with morbid obesity (body mass index [BMI]≥30 kg/m2) and to compare the effects of KM counseling and non-counseling on weight loss. Methods: We performed a retrospective chart review of patients with morbid obesity who received KM treatment for at least 1 month. We evaluated the effects of KM treatment on body weight, BMI, body fat, fat mass, EuroQol-5D, and the Korean version of the obesity-related quality of life scale (KOQOL). We also assessed the liver and kidney functions, and adverse events. We performed a comparative analysis between the counseling and non-counseling groups. Results: A total of 37 patients who underwent 4 weeks of KM treatment involving Wolbi-tang, electroacupuncture, and KM counseling were included in this study. Twenty-one patients were assigned to the counseling group and sixteen patients to the non-counseling group. There was a significant decrease in weight, BMI, fat mass, and KOQOL (P<0.05) with improvements in total cholesterol, low-density lipoprotein, and triglycerides. The counseling group had a greater reduction in body weight, BMI, body fat, and fat mass compared to the non-counseling group, although it was not significant. In the BMI below 35 (n=25), the reduction ratio of body weight, body fat mass, and body fat was higher in the counseling group than in the non-counseling group; additionally, body fat decreased significantly in counseling group (P<0.05). No severe adverse effects were observed. Conclusion: KM treatment could be effective for weight loss, especially in patients with morbid obesity, KM counseling could also be a good tool for weight loss, typically in patients with BMI<35 kg/m2.

A Study on Weight Loss Effect and Safety of Integrated Korean Medicine Treatment on Obese Patients in Local Clinics: A Restrospective Chart Review (한의원 진료환경에서 비만환자 대상 한의통합치료의 체중 감량 효과 및 안전성에 관한 연구: 후향적 차트 리뷰)

  • Ojin Kwon;Changsop Yang;Young Jin Kim;Won Hae Ku;Won Gu Lee;Ki Byung Kim;Kyung Hwan Jegal
    • Journal of Korean Medicine for Obesity Research
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    • v.22 no.2
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    • pp.125-135
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    • 2022
  • Objectives: A restrospective chart review were conducted to investigate the overall weight loss effect of the integrated Korean medicine treatment on obese patients (body mass index [BMI] ≥25 kg/m2) in Korean medicine clinic and analyze the difference in the effect according to lifestyle behaviors. Methods: The medical records of 43 obese patients were retrospectively analyzed including body weight, BMI, waist circumference, hip circumference, and body composition who received integrated Korean medicine treatment for 4 weeks at 24 Korean medicine clinics in Daejeon metropolitan city. All outcome measures were evaluated again 8 weeks after the end of treatment at week 12 for follow-up. EuroQol-5D (EQ-5D), the Korean version of the obesity-related quality of life scale (KOQOL) and patient's satisfaction were also evaluated. The analysis was divided according to the treatment period and observation period, and subgroup analysis was performed according to drinking and exercise habits. Results: Body weight, body fat, waist circumference, hip circumference, body fat were significantly reduced at week 4 and week 12. Theses weight reduction effects were significantly greater within treatment period (0 to 4 week) than observation period (4 to 12 week). Especially in the non-exercise group, the changes in body fat mass and body fat percent showed a significant difference between the treatment period and the observation period. KOQOL were also significantly improved at 12 week, but not in EQ-5D. No severe adverse events were observed. Conclusions: The integrated Korean medicine treatment could be effective to treat obesity including weight loss. It is necessary to prevent additional weight regain through regular exercise even after Korean medicine treatment.

Multicenter, Open-Labeled, Observational Clinical Trial to Investigate the Efficacy and Safety of Oral Administration of Megace Suspension in Patients with Head and Neck Cancer During Radiotherapy (방사선 치료 중인 두경부 종양 환자를 대상으로 메게이스 내복 현탁액 경구투여 후 유효성 및 안전성에 관한 다기관, 공개, 관측연구)

  • Kim, Se-Heon;Kim, Min-Sik;Kim, Young-Mo;Kim, Hyun-Su;Nam, Soon-Yuhl;Rho, Young-Soo;Park, Young-Hak;Baek, Chung-Hwan;Bong, Jung-Pyo;Lee, Kang-Dae;Lee, Yong-Seop;Jung, Kwang-Yoon;Chung, Sung-Min;Chung, Pil-Sang;Joo, Young-Hoon;Chu, Hyung-Ro;Choi, Eun-Chang;Tae, Kyung;Hong, Ki-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.1
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    • pp.57-63
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    • 2008
  • Background and Purpose:Nausea, vomiting and weight loss are common problems that are encountered in the course of cancer patient treatment who are receiving radiotherapy. In this study, we are aiming to analyze the effect of megestrol acetate on quality of life of head and neck cancer patients receiving radiotherapy, resulting from improvement of weight loss, appetite and nutritional status via multicenter, open-labeled, observational clinical trial. Material and Methods:A total of 270 patients from 10 medical institutes who are receiving radiotherapy or who have completed radiotherapy within 3 months, between February 2007 and February 2008, were selected as candidates for the study. Megestrol acetate suspension(megace) was given to the subjectives once a week for 4 weeks with the amount of 20ml(megestrol 800mg). Measurement of weight and questionnaire surveys were carried out three times: at the start of the study, 4 weeks after the start of the medication, and 4 weeks after the end of the medication, respectively. Results:The group who has received megace had a total number of 199, and control group was 70. The group who have received megace showed mean weight loss of 1kg in 8 weeks, compared with the weight loss of 5.5kg in control group, which showed that the medication was effective in reducing the amount of weight loss(P=0.027). The group who received megace had a tendency to report a reduced rate of decrease in the score of appetite, nausea and vomiting, and QOL score, but it did not have statistical significance(P>0.05). Conclusion:Megestrol acetate have reduced the degree of weight loss significantly, and it has a tendency to reduce the rate of decrease in appetite, aggravation of nausea and vomiting, and quality of life.

The Analysis of Research Trend about Hospice in Korea ($1991{\sim}2004$) (국내 호스피스 논문 분석($1991{\sim}2004$))

  • Kim, Sang-Hee;Choi, Sung-Eun;Kang, Sung-Nyun;Park, Jung-Suk;Sohn, Sue-Kyung;Kang, Eun-Sil;Lee, Young-Eun
    • Journal of Hospice and Palliative Care
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    • v.10 no.3
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    • pp.145-153
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    • 2007
  • Purpose: This study was to analyze the research trend centering on the theses to hospice released in Korea. Methods: The researcher collected the academic degrees and theses published on the book of the academic society from 1991 to 2004, and examined 110 domestic papers of hospice. Results: 1) The number of articles increased 3 years after 1997, 52 (47%) theses were published in $2000{\sim}2002$. 97 (88%) articles were quantitative studies, and 13 (12%) were qualitative studies. 2) As for the subject, the results were: patients with end stage 44 (40%), nurse 18 (16%), hospice care system, facilities, and literature review 12 (10%). 3) As for main concepts of correlational studies 15 (13%), the results were: quality of life, activities of volunteers, suffering experience of nurse, and so on. 4) The subjects and contents of survey, the results were: pain control and need for nursing care in patients, need for spiritual and physical care in family, and so on. 5) The treatment of experimental research, the results were: hospice nursing, educational program, informational support, spiritual nursing, supportive nursing intervention, home hospice care, information services for control of cancer pain, and so on. 6) In the theme of the qualitative studies, the results were: experience of dying patients, perceive of hospice care and death, experience of family of terminal ill patients, meaning of dying in Korean. 7) In the instrument in studies, the results were: MQOL, EQOL, QOL, NIC, Need Scale, Spiritual Well-being Scale, Spiritual Perspective Scale, Coping for Grief Scale, K-CPAT, VAS, BPI, Depression Scale, Strait-anxiety Scale, Care-giver Burden Inventory, Burnout Inventory, Mental quality. Conclusion: More research needs to be encouraged in experimental and qualitative research fields. Researches should be conducted for the establishment of the basis of practical and theoretical framework and hospice polices.

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Exploratory Study of Person Centered Care Practice in Korean Long-term Care Facilities using DCM(Dementia Care Mapping) as a tool (DCM(Dementia Care Mapping)을 활용한 한국 요양시설에서의 사람중심케어 실천의 탐색적 연구)

  • Kim, Dongseon
    • 한국노년학
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    • v.41 no.2
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    • pp.197-215
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    • 2021
  • This study aims to evaluate Person Centered Care practice and characteristics of care services in Korean long-term care facilities using Dementia Care Mapping as a tool. DCM, systematic observational evaluation tool for measuring dementia patients' QOL, was transformed into self-report rating scale. The process of transforming DCM into a scale of 34 items involves operationalization of DCM concepts and it's adaptation into Korean long-term care practices. Review by research team of Bradford university was added to maintain DCM concept and meaning in this scale. The scale with Cronbach alpha of .88 was surveyed on 343 care workers. Survey result shows PCC value practiced by them is 3.77(of 5 likert scale) and values on each categories of PCC reveal the characteristics of care in Korean facilities; attachment(4.02), comfort(3.95), inclusion(3.89), identity(3.67) and occupation(3.41). Dementia care in Korean facilities focuses on recipients'safety, comfort but lacks individualistic care and the meaningful and fulfilling occupation for patients. Looking at the organizational and individual factors influencing DCM values, the small facilities showed higher PCC values and there are no significant difference in PCC values between public and private facilities. Managers and care workers with career of 1~2 years showed higher PCC values compared to other career ranks and lengthes. This study suggests care practice should be centered on personhood of patients in long-term care facilities, for which introduction of unit care and education of PCC for service providers including support personnel are needed. DCM and Korean DCM scale developed in this study are suggested for the PCC-based assessment on care quality.

Compilation of 104 Experimental Theses on the Antitumor and Immuno-activating therapies of Oriental Medicine (한의학의 항종양 면역치료에 관한 연구 -1990년 이후 발표된 실험논문을 중심으로-)

  • Kang Yeon Yee;Kim Tai Im;Park Jong Ho;Kim Sung Hoon;Park Jong Dai;Kim Dong Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.1
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    • pp.1-24
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    • 2003
  • This study was done to compile 104 experimental theses which are related to the antitumor and immuno-activating therapies between February 1990 through February 2002. Master's and doctoral theses were dassified by schools, degrees, materials, effects, experimental methods of antitumor and immunoactivity, and results. The following results were obtained from this study : 1. Classifying the theses by the school, 34.6% were presented by Daejeon University, 29.8% by Kyung-hee University and 11.5% by Won-kwang University. Of all theses, 51.0% were aimed for the doctoral degree and 43.3% were for the master's degree. All of three universities have their own cancer centers. 2. Classifying the theses by herb materials, complex prescription accounted for 60.3%, single herb accounted for 24.8% and herbal acupuncture accounted for 14.2%. Considering the key principles of the traditional medicine, complex prescription was much more thoroughly studied than single herb prescription. The results showed that the complex prescription had both antitumor activity and immuno-activating activity, which might reflects on multi-activation mechanisms by complex components. 3. Classifying the theses by the efficacy of herbs examined, in single herb, invigorating spleen and supplementing was 35.5%, expelling toxin and cooling was 29.0%, activating blood flow and removing blood stasis was 12.9%. In herbal acupuncture, invigorating spleen and supplementing was 52.9%, expelling toxin and cooling was 29.4%. In complex prescription, pathogen-free status was 41.9%, strengthening healthy qi to eliminate pathogen was 35.5%, strengthening healthy qi was 22.6%. It is presumed that the antitumor and immunoactivating therapy based on syndrome differentiation is the best way to develop oriental oncology. 4. Classifying the theses by antitumor experiments, cytotoxic effect was 48.1 %, survival time was 48.1 % and change of tumor size was 42.3%. Survival rate was not necessarily correlated with cytotoxicity. These data reflect the characteristic, wholistic nature of the oriental medicine which is based on BRM (biological response modifier). 5. Classifying the theses by immunoactivating experiments, hemolysin titer was 51.0%, hemagglutinin titer was 46.2% and NK cell's activity was 44.2%. In the future studies, an effort to elucidate specific molecular and cellular mechanisms of cytokine production in the body would be crucial. 6. Classifying the theses according to the data in terms of antitumor activity, 50% was evaluated good, 24.0% was excellent, and 15.5% have no effect. In an evaluation of immuno-activating activity, 35.9% was excellent and 18.0% showed a little effect. The index point, as described here, may helps to use experimental data for clinical trials. Changes in index points by varying dosage implicate the importance of oriental medical theory for prescription. 7. In 167 materials, IIP (immunoactivating index point, mean : 3.12±0.07) was significantly higher than AIP(antitumor index point, mean : 2.83±0.07). These data demonstrate that the effect of herb medicine on tumor activity depends more on immunoactivating activity than antitumor activity. This further implies that the development of herbal antitumor drugs must be preceded by the mechanistic understanding of immunoactivating effect. 8. After medline-searching tumor and herb-related articles from NCBI web site, we conclude that most of the studies are primarily focused on biomolecular mechanisms and/or pathways. Henceforth, we need to define the biomolecular mechanisms and/or pathways affected by herbs or complicated prescriptions. 9. Therefore, the most important point of oriental medical oncology is to conned between experimental results and clinical trials. For the public application of herbal therapy to cancer, it is critical to present the data to mass media. 10. To develop the relationship of experimental results and clinical trials, university's cancer clinic must have a long-range plan related to the university laboratories and, at the same time, a regular consortium for this relationship is imperative. 11. After all these efforts, a new type herbal medicine for cancer therapy which is to take care of the long-term administering and safety problem must be developed. Then, it would be expected that anti-tumor herbal acupuncture can improve clinical symptoms and quality of life (QOL) for cancer patients. 12. Finally, oriental medical cancer center must be constructed in NCC (National Cancer Center) or government agency for the development of oriental medical oncology which has international competitive power.