• Radiation Oncology Journal
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• 제34권2호
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• pp.81-87
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• 2016

Hypofractionated whole breast irradiation (HF-WBI) has been proved effective and safe and even better for late or acute radiation toxicity for early breast cancer. Moreover, it improves patient convenience, quality of life and is expected to be advantageous in the medical care system by reducing overall cost. In this review, we examined key randomized trials of HF-WBI, focusing on adequate patient selection as suggested by the American Society of Therapeutic Radiology and Oncology (ASTRO) guideline and the radiobiologic aspects of HF-WBI in relation to its adoption into clinical settings. Further investigation to identify the current practice pattern or cost effectiveness is warranted under the national health insurance service system in Korea.

• 대한한방부인과학회지
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• 제21권3호
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• pp.200-217
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• 2008

Purpose: The aim of this study is to review and analyze the status on the obstetric and gynecologic RCTs with acupuncture. Methods: Searching were performed in $7{\sim}14$ July, 2008. Search term used was "acupuncture" only. And we classified all the searched articles as diseases and related health problems. Then we also classified OBGY diseases and analyzed the trends of those parts. Results: We could search 666 articles, RCTs with acupuncture. Of them, we found 88 OBGY articles about nausea and vomiting in pregnancy, labor and postpartum. OBGY surgery, hot flashes and climacteric, ART, Disease with Pregnancy women and menstruation, fetal breech presentation, and breast disease etc. Conclusion: To improve traditional Korean OBGY research, it is needed activation of RCT research, study of meta analysis, development of clinical practice guidelines, variation of research subject, and co-works with conventional medicine.

• Clinical and Experimental Reproductive Medicine
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• 제48권1호
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• pp.11-26
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• 2021

Advances in anticancer treatments have resulted in increasing survival rates among cancer patients. Accordingly, the quality of life after treatment, particularly the preservation of fertility, has gradually emerged as an essential consideration. Cryopreservation of embryos or unfertilized oocytes has been considered as the standard method of fertility preservation among young women facing gonadotoxic chemotherapy. Other methods, including ovarian suppression and ovarian tissue cryopreservation, have been considered experimental. Recent large-scale randomized controlled trials have demonstrated that temporary ovarian suppression using gonadotropin-releasing hormone agonists (GnRHa) during chemotherapy is beneficial for preventing chemotherapy-induced premature ovarian insufficiency in breast cancer patients. It should also be emphasized that GnRHa use during chemotherapy does not replace established fertility preservation methods. All young women facing gonadotoxic chemotherapy should be counseled about and offered various options for fertility preservation, including both GnRHa use and cryopreservation of embryos, oocytes, and/or ovarian tissue.

• Medical Lasers
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• 제10권4호
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• pp.189-194
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• 2021

Breast cancer-related lymphedema (BCRL) is characterized by the persistent accumulation of interstitial fluid in the peripheral tissues after treatment for breast cancer. Photobiomodulation (PBM) therapy is widely used as supportive care for patients with BCRL. A search was performed in the PubMed database to find relevant articles published over the last 20 years. Randomized controlled trials that evaluated the efficacy of PBM therapy on BCRL were included. A total of 24 studies were identified through the PubMed database. Seven studies were used for the final analysis, after excluding items that did not meet the duplication and inclusion criteria. Although PBM showed some improvement in reducing arm circumference and the symptoms related to BCRL, the results of the meta-analysis did not show any significant benefit in alleviating lymphedema. Further studies are needed with the recruitment of more participants to evaluate the long-term efficacy and safety of PBM in the management of BCRL.

• Journal of Acupuncture Research
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• 제40권2호
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• pp.129-134
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• 2023

In this review, we searched for clinical and experimental studies related to acupuncture-related therapy (ART) on the microbiome in musculoskeletal disorders (MSDs) through the electronic databases of MEDLINE via PubMed, EMBASE, and Oriental Medicine Advanced Searching Integrated System up to May 2023, without language restriction, and after the selection/exclusion process, the study design, target disease, intervention details, treatment period, outcomes, and study results were extracted. A total of 8 articles were selected. Two randomized controlled trials and 6 animal studies evaluated knee osteoarthritis, rheumatoid arthritis, spinal cord injury, ankylosing spondylitis, and osteoporosis. ART, including electroacupuncture, thread-embedding acupuncture, and moxibustion, affected microbiome modulation in MSDs. The results reveal that ART could be a potential treatment for regulating the microbiome in MSDs. However, further high-quality studies are needed.

• Korean Journal of Radiology
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• 제22권3호
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• pp.442-453
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• 2021

Artificial intelligence (AI) will likely affect various fields of medicine. This article aims to explain the fundamental principles of clinical validation, device approval, and insurance coverage decisions of AI algorithms for medical diagnosis and prediction. Discrimination accuracy of AI algorithms is often evaluated with the Dice similarity coefficient, sensitivity, specificity, and traditional or free-response receiver operating characteristic curves. Calibration accuracy should also be assessed, especially for algorithms that provide probabilities to users. As current AI algorithms have limited generalizability to real-world practice, clinical validation of AI should put it to proper external testing and assisting roles. External testing could adopt diagnostic case-control or diagnostic cohort designs. A diagnostic case-control study evaluates the technical validity/accuracy of AI while the latter tests the clinical validity/accuracy of AI in samples representing target patients in real-world clinical scenarios. Ultimate clinical validation of AI requires evaluations of its impact on patient outcomes, referred to as clinical utility, and for which randomized clinical trials are ideal. Device approval of AI is typically granted with proof of technical validity/accuracy and thus does not intend to directly indicate if AI is beneficial for patient care or if it improves patient outcomes. Neither can it categorically address the issue of limited generalizability of AI. After achieving device approval, it is up to medical professionals to determine if the approved AI algorithms are beneficial for real-world patient care. Insurance coverage decisions generally require a demonstration of clinical utility that the use of AI has improved patient outcomes.

• 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.

• 동의신경정신과학회지
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• 제27권4호
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• pp.261-274
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• 2016

Objectives: To determine the general characteristics of clinical studies about Hwabyung and assess their limitations and alternatives. Methods: Clinical studies that examined the effects of traditional Korean medicine intervention on Hwabyung were included in this study. A systematic search of English, Chinese, Japanese, and Korean databases was performed. The characteristics of included articles were described and those articles were assessed by Risk of Bias (RoB) tool or Risk of Bias for Nonrandomized Studies (RoBANS) tool. Results: Sixteen articles were selected from 1,826 articles. Most clinical studies about Hwabyung were published in Korea. The number of conducted trials was insufficient. The prevailing study design was randomized controlled trial. Traditional Korean medicine intervention used in the trials were acupuncture, herbal medicine, counselling, meditation, emotional freedom technique (EFT), music therapy, art therapy, and multi intervention program. Herbal medicine study used placebo as control while non-pharmacological intervention study mostly used no treatment as control. Most of the trials were supported by the government. Therefore, financial conflict of interest might not exist for results. We judged that some studies had a high risk of bias. In general, most of the studies with a high risk of bias were non-pharmacological intervention studies, and the risk of bias was mainly due to lack of blinding. Conclusions: More clinical studies of Hwabyung are needed. There are some issues about a suitable comparison and effective blinding strategy for non-pharmacological study. Improving methodological quality is required.

• The Journal of Advanced Prosthodontics
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• 제4권2호
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• pp.76-83
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• 2012

PURPOSE. Zirconia has been used in clinical dentistry for approximately a decade, and there have been several reports regarding the clinical performance and survival rates of zirconia-based restorations. The aim of this article was to review the literatures published from 2000 to 2010 regarding the clinical performance and the causes of failure of zirconia fixed partial dentures (FPDs). MATERIALS AND METHODS. An electronic search of English peer-reviewed dental literatures was performed through PubMed to obtain all the clinical studies focused on the performance of the zirconia FPDs. The electronic search was supplemented by manual searching through the references of the selected articles for possible inclusion of some articles. Randomized controlled clinical trials, longitudinal prospective and retrospective cohort studies were the focuses of this review. Articles that did not focus on the restoration of teeth using zirconia-based restorations were excluded from this review. RESULTS. There have been three studies for the study of zirconia single crowns. The clinical outcome was satisfactory (acceptable) according to the CDA evaluation. There have been 14 studies for the study of zirconia FPDs. The survival rates of zirconia anterior and posterior FPDs ranged between 73.9% - 100% after 2 - 5 years. The causes of failure were veneer fracture, ceramic core fracture, abutment tooth fracture, secondary caries, and restoration dislodgment. CONCLUSION. The overall performance of zirconia FPDs was satisfactory according to either USPHS criteria or CDA evaluations. Fracture resistance of core and veneering ceramics, bonding between core and veneering materials, and marginal discrepancy of zirconia-based restorations were discussed as the causes of failure. Because of its repeated occurrence in many studies, future researches are essentially required to clarify this problem and to reduce the fracture incident.

• Journal of Evidence-Based Herbal Medicine
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• 제1권2호
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• pp.35-43
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• 2008

Herbal medicines have an accurate effect on atopic dermatitis, and at the same time, they hardly have adverse reactions. However, herbal medicines are difficult to be quantitatively analyzed due to low-quality preparation and types. In addition, herbal medicines have raised many problems as they have not been standardized and their active components have not been analyzed. Patients with atopic dermatitis began to recognize the effectivity and safety of herbal medicines. Accordingly, standardization, biological analyses, animal experiments and clinical trials should be generally performed in order that herbal medicines may be recognized all over the world. A standard, which is to objectively judge the curative effect of atopic dermatitis, should be established as soon as possible. Case studies and RCTs (Randomized Controlled Trials) should be actively performed on the basis of rigid clinical trial design to the end that the curative effect of herbal medicines is recognized all the world over.