• Journal of Pharmacopuncture
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• v.23 no.1
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• pp.8-17
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• 2020

Aim of the study: The objective of this systematic review is to critically evaluate the evidence of the effectiveness and safety of external application of herbal medicines (EAHM) for acne vurgalis (AV). Methods: English, Chinese and Korean language databases were searched up to May 2018. Randomized clinical trials (RCTs) that reported the effects of EAHM for AV were included and analysed. Results: A total of 10 randomized trials with 656 AV patients were identified. A meta-analysis of two RCTs indicated that EAHM had a significant effect on improving primary outcome 'global assessment' compared with placebo (mean difference (MD) = -2.62, confidence interval (CI) = -4.84 to -0.40, p = 0.02). Furthermore, data extracted from two RCTs showed that EAHM significantly reduce primary outcome 'inflammatory lesion count of acne' (MD = -1.25, CI = -1.68 to -0.83, p < 0.00001) and 'non-inflammatory lesion count of acne' (MD = -1.32, CI = -1.75 to -0.90, p < 0.00001). No significant difference was observed between groups in secondary outcome 'sebum of skin' (MD = -0.21, CI = -0.53 to 0.11, p = 0.20) and 'patient-reported changes in symptom' (relative risk (RR) = 2.56, CI = 0.43 to 15.22, p = 0.30). No severe adverse events (AEs) were found and no treatment was stopped due to AEs of EAHM. Conclusions: EAHM seems to have affirmative effects, but quality of evidence, and non-standardized use of EAHM make our conclusion weak. Our suggestion is rigorously designed RCTs and standardization of EAHM are required in the future.

• Herbal Formula Science
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• v.28 no.2
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• pp.199-209
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• 2020

Objectives : The purpose of this systematic review is to confirm whether Gwibitang is beneficial in chronic fatigue syndrome (CFS). Methods : Clinical trials were searched from databases including Pubmed, Embase, Central Cochrane, CNKI, Wanfang, CQVIP, CiNii, OASIS, Koreamed, and NDSL. The eligible study design was limited into randomized controlled trial, quasi-randomized controlled trial and controlled clinical trial. The outcomes included general effectiveness as nominal scale, and fatigue severity, insomnia severity and quality of life as interval or ratio scale. The meta-analysis and assessment of risk of bias was performed based on the data extracted from the selected trials. Results : The results of eight randomized controlled trials (n=596) were included in the meta-analysis. The results of the synthesis showed Gwibitang is beneficial substantially for relieving and managing the general symptoms, and its heterogeneity was not in important level (RR 0.26 [95% CI 0.17, 0.39], Z=6.47, P<0.00001, I²=0%). Gwibitang was beneficial for alleviating fatigue (SMD -0.78 [95% CI -1.27, -0.30], Z=3.17, P=0.002), but its certainty was low. In case of insomnia, too few trials had been found and their risk of bias was substantial, so no conclusions had been brought to. Conclusions : We found an evidence that Gwibitang could be beneficial for managing and alleviating main symptoms in CFS patients.

• Science of Emotion and Sensibility
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• v.15 no.3
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• pp.345-354
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• 2012

The purpose of this study is finding alternative parameters of the HRV so as to minimize the subjective errors by STAI and BDI, could be have two types of significant correlation levels depending on normalized method. Particularly, the LF/HF presented as the quantitative physiological parameter that can reflect both state-anxiety and trait-anxiety.

• Korean Journal of Clinical Pharmacy
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• v.29 no.2
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• pp.115-124
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• 2019

The purpose of this systematic review and meta-analysis was to assess the preventive effect of theophylline on acute kidney injury and the ameliorative effect of theophylline on renal function in asphyxiated neonates. A literature search of the PubMed/Medline, Embase, and Cochrane Library databases for information published up to February 2019 was conducted. All studies that reported the incidence rate of acute kidney injury, serum creatinine level, and glomerular filtration rate after the randomized administration of theophylline or placebo were included. In total, eight studies involving 498 neonates were eligible. The incidence rate of acute kidney injury was significantly lower in the theophylline group than in the placebo group (risk ratio [RR]: 0.42, 95% confidence interval [CI]: 0.32-0.55, p < 0.001). The changes in serum creatinine level in the theophylline group were significantly higher than those in the placebo group from the first day of life to 3 and 5 days of age (weighted mean difference [WMD]: -0.51, 95% CI: -0.62 to -0.40, p < 0.001, and WMD: -0.26, 95% CI: -0.34 to -0.18, p < 0.001, respectively). The changes in glomerular filtration rate in the theophylline group were significantly higher than those in the placebo group from the first day of life to 3 days of age and the last day of follow-up (WMD: 12.30, 95% CI: 9.39-15.21, p < 0.001, and WMD: 9.35, 95% CI: 6.43-12.27, p < 0.001, respectively). These results suggested that theophylline has a beneficial effect on the prevention of acute kidney injury in neonates with perinatal asphyxia.

• Journal of Chest Surgery
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• v.56 no.6
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• pp.374-386
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• 2023

Background: The heightened morbidity and mortality associated with repeat cardiac surgery are well documented. Redo median sternotomy (MS) and minimally invasive valve surgery are options for patients with prior cardiac surgery who require mitral valve surgery (MVS). We conducted a systematic review and meta-analysis comparing the outcomes of redo MS and minimally invasive MVS (MIMVS) in this population. Methods: We searched PubMed, EMBASE, and Scopus for studies comparing outcomes of redo MS and MIMVS for MVS. To calculate risk ratios (RRs) for binary outcomes and weighted mean differences (MDs) for continuous data, we employed a random-effects model. Results: We included 12 retrospective observational studies, comprising 4157 participants (675 for MIMVS; 3482 for redo MS). Reductions in mortality (RR, 0.54; 95% confidence interval [CI], 0.37-0.80), length of hospital stay (MD, -4.23; 95% CI, -5.77 to -2.68), length of intensive care unit (ICU) stay (MD, -2.02; 95% CI, -3.17 to -0.88), and new-onset acute kidney injury (AKI) risk (odds ratio, 0.34; 95% CI, 0.19 to 0.61) were statistically significant and favored MIMVS (p<0.05). No significant differences were observed in aortic cross-clamp time, cardiopulmonary bypass time, or risk of perioperative stroke, new-onset atrial fibrillation, surgical site infection, or reoperation for bleeding (p>0.05). Conclusion: The current literature, which primarily consists of retrospective comparisons, underscores certain benefits of MIMVS over redo MS. These include decreased mortality, shorter hospital and ICU stays, and reduced AKI risk. Given the lack of high-quality evidence, prospective randomized control trials with adequate power are necessary to investigate long-term outcomes.

• The Journal of Korean Medicine
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• v.30 no.1
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• pp.120-127
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• 2009

Objectives: Sahyangsohapwon (SS) is a herbal medication that has been widely used with circulatory and neural diseases. This study was conducted to assess the effect of SS on the autonomic nervous system by using heart rate variability measurement. Methods: The eligible subjects were enrolled from the healthy male group of ages 20 to 35 years. They were divided into two groups, the SS group (n=26) and the control (n=24). We monitored the ECG of subjects from the time period 14:00 to 18:00. In the SS group, subjects were administered with a dose of SS at the time 15:00, whereas the control group had none. For each hour HRV measurement was monitored every 15 minutes for 512 seconds from the time period 14:00 to 18:00. The mean value, which was calculated using the 4 values during each hour (i.e. 14:00, 14:15, 14:30, 14:45), was used as the representative value for each individual hour. For the measurement values, RR-interval and SDNN (standard deviation of the NN intervals) were used as time domain analysis, and HF (high frequency), LF (low frequency), and LF/HF ratio were used as frequency domain analysis. Results: The LF value showed an increase after one hour of SS administration and showed gradual diminution for each and every hour. The repeated measures of ANOVA for the comparison of the LF value between the SS group and the control group showed significant differences. While, RR interval, SDNN, HF, and LF/HF ratio values showed no significant differences between the two groups. Conclusions: We suggest that the SS might be useful for stabilizing autonomic nervous system by inhibiting sympathetic nerve activation in healthy people.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.5
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• pp.485-493
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• 2007

Purpose: Heart rate variability(HRV) is the clinical consequence of various influences of the autonomic nervous system(ANS) on heart beat. HRV can estimate the potential physiologic rhythm from the interval between consecutive beats(RR interval or HRV data). It is known as RSA which represents respiration-related HR rhythmic oscillation. Previous studies demonstrated a specific breathing pattern(0.1Hz, 6breaths/min) to improve a physiological body condition related to the stress. In this paper, the level of stress would be evaluated in terms of three phases of the dental treatment, combined with 6breaths/min. Methods: These phases include before, during and after tooth extraction or anesthesia or something.36 patients' stresses were assessed using HRV stress analyzer in each phase in Kangdong Sacred Heart Hospital, and Chuncheon Sacred Heart Hospital, Hallym University Medical Center from Jun. to Sept. of 2007. HRV 5-min data collected were analyzed in time-domain and frequency-domain to evaluate the activity of autonomic nervous system(ANS) which represents the level of stress. Results: All HRV parameters including HF(high frequency), LF(low frequency) and LF/HF ratio showned a significant change affecting the ANS balance. There was a 6.4% difference between R(LF/HF)s on general breathing pattern for balance of Autonomic nervous system, but on controlled breathing pattern, 0.1Hz, was made narrow till 1.4%. The activity of ANS has increased by 1.4% on general breathing pattern, and by 2.9% on controlled breathing pattern, 0.1Hz. Conclusion: After analysis of preoperative stress changes and effect of breathing pattern of 0.1 Hz on the stress in 36 patients who have undergone third molar extraction, following was concluded. In the preoperative stage, the sympathetic change was the greatest?after the?anesthetic injection, and stress was relieved by controlling the breathing pattern to a frequency of 0.1Hz.

• Journal of Yeungnam Medical Science
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• v.24 no.2
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• pp.216-231
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• 2007

Background : An acceleration or deceleration of the heart rate (HR), which reflects autonomic effects, is observed before the onset of paroxysmal atrial fibrillation (PAF). The purpose of this study was to assess the discrepancy in the autonomic interactions before the onset of PAF for different patterns of change in the HR. Materials and Methods : From 105 Holter tapes with the PAF recorded, 55 episodes (42 patients, 34 men, $58{\pm}12$ years) of PAF (>5 min), preceded by a sinus rhythm for more than 1 hour, were selected and submitted to time-domain and frequency-domain HR variability analyses. Fifty-five episodes were divided into 2 groups: group A PAF (n=30) with acceleration of the HR during the last 2 minutes before the PAF and group B (n=25) with deceleration of the HR. Results : A significant linear decrease in the mean R-R interval was observed in group A ($924{\pm}30$ to $835{\pm}28ms$, $P$=0.001) and an increase from $831{\pm}32$ to $866{\pm}31ms$ in group B PAF episodes ($P$=0.046). In the frequency-domain analyses, the LF/HF ratio exhibited a progressive linear increase before the PAF in group A ($P$=0.005). The HF normalized units (HFnu) and natural logarithm-transformed HF ($In$HF) values decreased from $30.8{\pm}4.0$ to $16.1{\pm}1.8$ ($P$=0.003) and $4.49{\pm}0.25$ to $4.07{\pm}0.22$ ($P$=0.001), respectively. Contrary to the results in group A, a significant increase in the HF components (HFnu and $In$HF) (from $22.6{\pm}3.2$ to $30.2{\pm}4.0$, $P$=0.005, and $4.27{\pm}0.27$ to 4.75 0.33, $P$=0.001, respectively) and a resultant decrease in the LF/HF ratio were observed in group B PAF episodes. No significant changes were observed in the LF components in either PAF group. Conclusion : Autonomic stimuli leading to an acceleration or deceleration of the HR before the onset of AF are due to parasympathetic modulation. Parasympathetic modulation plays a key role in the initiation of PAF.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1929-1934
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• 2015

Purpose: To determine the diagnostic yield of primary circulating tumor cells in women with suspicion of breast cancer, detected as a result of an abnormal mammography. Materials and Methods: Consecutive women presenting for breast biopsy as a result of a mammogram BiRADs of 3 or more, had an 8ml blood sample taken for primary circulating tumor cell (CTC) detection. Mononuclear cells were obtained using differential gel centrifugation and CTCs identified using standard immunocytochemistry using anti-mammoglobin. A test was determined to be positive if 1 CTC was detected. Results: A total of 144 women with a mean age of $54.7{\pm}15.6$ years participated, 78/144 (53.0%) had breast cancer on biopsy, 65/140 (46.3%) benign pathologies and 1(0.7%) non-Hogkins lymphoma. Increasing BiRADs scores were associated with increased cancer detection (p=0.004, RR 1.00, 4.24, 8.50). CTC mammoglobin positive had a sensitivity of 81.1% and specificity of 90.9%, with positive and negative predictive values of 90.9% and 81.1% respectively. Mammoglobin positive CTCs detected 87% of invasive cancers, while poorly differentiated cancers were negative for mammoglobin. Only 50% of in situ cancers and none of the intraductal cancers had CTCs detected. Menopausal status did not affect the diagnostic yield of the CTC test, which was higher in women with BiRADS 4 mammograms. There was a significant trend (p<0.0001 Chi squared for trends) in CTC detection frequency from intraductal, in situ and invasive (OR 1.00, 8.00, 472.00). Conclusions: The use of primary CTC detection in women suspected of breast cancer has potential uses, especially with invasive cancer, but it failed to detect intra-ductal cancer and 50% of in situ cancer. There was no difference in the diagnostic yield between pre and post menopausal women. To confirm its use in reducing biopsies in women with BIRADs 4a mammagrams and in the detection of interval invasive breast cancer, larger studies are needed.

• Korean Journal of Psychosomatic Medicine
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• v.21 no.1
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• pp.55-61
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• 2013

Objectives : Alzheimer's disease(AD) and mild cognitive impairment(MCI) affect several nervous structures involved with the autonomic nervous system. Association between neuropsychiatric deficits and heart rate variability has been observed. But cardiac autonomic function in AD has been scarcely studied and the results reported are conflicting. We investigated autonomic function in normal control, MCI, AD using heart rate variability(HRV) technique. Methods : Time and frequency-domain variability of 5-min R-R interval series was comparatively evaluated in 26 normal control subjects, 22 MCI subjects and 34 AD subjects. Analysis of variance(ANOVA) was used to compare the differences across groups. Correlations between MMSE-KC and HRV components were performed using Pearson's correlation coefficient. Results : No significant difference was observed among the groups in time, frequency-domain analysis of HRV(p>0.05). HRV were not found to be significantly correlated with the degree of cognitive impairment. Conclusions : There were no differences in HRV with MCI, AD subjects when compared with normal controls. Further investigation is required to use HRV technique as noninvasive parameters of MCI and AD.