• Clinical Endoscopy
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• 제57권3호
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• pp.283-292
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• 2024

We developed three e-learning systems for endoscopists to acquire the necessary skills to improve the diagnosis of early gastric cancer (EGC) and demonstrated their usefulness using randomized controlled trials. The subjects of the three e-learning systems were "detection", "characterization", and "preoperative assessment". The contents of each e-learning system included "technique", "knowledge", and "obtaining experience". All e-learning systems proved useful for endoscopists to learn how to diagnose EGC. Lecture videos describing "the technique" and "the knowledge" can be beneficial. In addition, repeating 100 self-study cases allows learners to gain "experience" and improve their diagnostic skills further. Web-based e-learning systems have more advantages than other teaching methods because the number of participants is unlimited. Histopathological diagnosis is the gold standard for the diagnosis of gastric cancer. Therefore, we developed a comprehensive diagnostic algorithm to standardize the histopathological diagnosis of gastric cancer. Once we have successfully shown that this algorithm is helpful for the accurate histopathological diagnosis of cancer, we will complete a series of e-learning systems designed to assess EGC accurately.

• 대한치매학회지
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• 제21권1호
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• pp.1-16
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• 2022

Background and purpose: We investigated existing nonpharmacological programs for people with dementia (PWD) to explore critical factors related to the effectiveness of these types of programs. Methods: We conducted a qualitative systematic literature review to identify nonpharmacological intervention programs developed for PWD and reviewed 36 randomized controlled trials. Among several outcomes reported in each study, we focused on the most common outcomes including quality of life (QoL), neuropsychiatric symptoms, depression, agitation, and cognition for further review. Results: Several factors were identified that might affect the outcomes of nonpharmacological interventions for PWD including study design, characteristics of the intervention, maintaining research participants, heterogeneity issues, and implementation fidelity. About half of studies in this review reported positive program effects on their targeted outcomes such as Well-being and Health for PWD on improving quality of life, neuropsychiatric symptoms and agitation; cognitive stimulation therapy on QoL, neuropsychiatric symptoms and cognition; and a stepwise multicomponent intervention on neuropsychiatric symptoms, depression and agitation. Conclusions: We found some programs even with a rigorous study design did not produce expected outcomes while other programs with poor designs reported positive outcomes, which necessitates further investigation on the validity of the assessments. Factors such as individual tailored and customized interventions, promoting social interactions, ease of administration and compatibility of interventions, and developing program theory need to be considered when developing nonpharmacological intervention programs.

• Korean Circulation Journal
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• 제54권7호
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• pp.363-381
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• 2024

With global aging, the number of patients with heart failure has increased markedly. Heart failure is a complex condition intricately associated with aging, organ damage, frailty, and cognitive decline, resulting in a poor prognosis. The relationship among frailty, sarcopenia, cachexia, malnutrition, and heart failure has recently received considerable attention. Although these conditions are distinct, they often exhibit a remarkably close relationship. Overlapping diagnostic criteria have been observed in the recently proposed guidelines and position statements, suggesting that several of these conditions may coexist in patients with heart failure. Therefore, a comprehensive understanding of these conditions is essential, and interventions must not only target these conditions individually, but also provide comprehensive management strategies. This review article provides an overview of the epidemiology, diagnostic methods, overlap, and prognosis of frailty, sarcopenia, cachexia, and malnutrition in patients with heart failure, incorporating insights from the FRAGILEHF study data. Additionally, based on existing literature, this article discusses the impact of these conditions on the effectiveness of guideline-directed medical therapy for patients with heart failure. While recognizing these conditions early and promptly implementing interventions may be advantageous, further data, particularly from well-powered, large-scale, randomized controlled trials, are necessary to refine personalized treatment strategies for patients with heart failure.

• Physical Therapy Rehabilitation Science
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• 제13권2호
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• pp.196-204
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• 2024

Objective: Cortical Visual Impairment (CVI) is a leading cause of pediatric blindness and the most common form of pediatric visual disability, particularly prevalent among children with cerebral palsy (CP). This systematic review synthesizes the latest research on various interventions for managing CVI, focusing on studies published in the last decade. Design: A systematic review Methods: A comprehensive search was conducted in March 2024 across several databases including MEDLINE, CINAHL, Embase, and Web of Science. Studies were selected based on inclusion criteria set under the PICOSD framework and were limited to those involving human subjects, published in English, and conducted within the past ten years. The selected studies included randomized controlled trials, observational studies, and case reports focusing on rehabilitation, therapy, and surgical interventions for CVI. Results: Out of 221 studies screened, 5 met the inclusion criteria and were reviewed in detail. These studies covered a range of interventions including physiotherapy, sensory integration training, visual training programs, neuromotor rehabilitation, and surgical procedures aimed at improving visual function and overall quality of life for CVI patients. Conclusions: The studies demonstrate the potential benefits of structured, early intervention programs that incorporate family involvement and are tailored to the unique needs of children with CVI. However, there remains a significant need for further research to establish evidence-based practices in this field.

• 대한한방소아과학회지
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• 제38권3호
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• pp.1-12
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• 2024

Objectives This study aimed to evaluate the efficacy and usefulness of thread-embedding therapy for pediatric enuresis by analyzing clinical evidence. Methods Six clinical studies on thread-embedding therapy for pediatric enuresis were selected from the China National Knowledge Infrastructure (CNKI) database, with a focus on traditional Chinese medicine. The study designs, patient characteristics, treatment methods, and safety assessments were analyzed. Results Among the six studies, four were case reports and two were randomized controlled trials. Thread-embedding therapy was performed two to four times, with intervals ranging from one week to one month. CV3 (中極), SP6 (三陰交), ST36 (足三里) were used frequently, and the total effective rate for thread-embedding therapy ranged from 88.89% to 100%. Conclusions Thread-embedding therapy is effective for pediatric enuresis; however, more research is needed to evaluate its safety.

• Journal of Korean Biological Nursing Science
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• 제26권3호
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• pp.163-176
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• 2024

Purpose: This study conducted a systematic literature review and meta-analysis on the effectiveness of aromatherapy in reducing restless legs syndrome (RLS) in hemodialysis patients. Methods: Using the population, intervention, comparison, outcome, study design framework, a search was conducted of eight electronic databases: PubMed, Cochrane, Embase-Ovid, CINAHL, Web of science, Scopus, PQDT, and RISS. The population was hemodialysis patients, and the intervention included aromatherapy aiming at RLS, compared to control groups receiving placebo or usual care. The outcome measured was RLS, and the study design was randomized controlled trials. Results: The analysis included seven articles presenting results from 10 studies, and the pooled overall effect of aromatherapy on RLS in hemodialysis patients was shown by a Hedge's g of -1.84 (95% confidence interval: -2.45 to -1.23). Meta-regression analysis revealed greater effectiveness in studies that received funding. Age over 60, lavender oil use, intervention duration of less than 4 weeks, sessions longer than 30 minutes, a routine care control group, and quality assessment score of 10 or less were associated with RLS reduction. Conclusion: The study concluded that aromatherapy is effective for managing RLS in hemodialysis patients.

• 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.

• 한방비만학회지
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• 제20권1호
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• pp.52-68
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• 2020

Objectives: The purpose of this study is to investigate the weight loss effects of auricular acupuncture in obese patients. Methods: Six databases (Research Information Sharing Service [RISS], Korean studies Information Service System [KISS], Oriental Medicine Advanced Searching Integrated System [OASIS], PubMed, The Cochrane Library, China National Knowledge Infrastructure [CNKI]) were searched up to May 20, 2020. Eight eligible randomized controlled trials were included the present study. The quality of included studies was assessed by the Cochrane risk of bias tool and a meta-analysis was performed by Review Manager software. A meta-analysis was conducted using a random-effects model and a subgroup analysis was performed to detect the sources of heterogeneity, identify the selection of acupuncture methods and explore its contributions to the weight loss effects. Results: Among 8 trials, 5 trials used auricular acupuncture and 2 trials used auricular acupressure, 1 trial used both types of intervention. Most commonly selected acupoints were Shenmen (TF4) and stomach (CO4). Treatment duration was six to twelve weeks, and total treatment session was six to twelve. Compared to the control groups, auricular acupuncture significantly decreased body weight, body mass index (BMI), high density lipoprotein-cholesterol (HDL) and ghrelin. For the selection of acupuncture methods, both methods performed similarly in most outcome except waist circumference (WC), body fat percentage (BFP), and triglycerides (TG). Conclusions: We found that auricular acupuncture can be effective for weight loss and controlling appetite. However, the findings should be interpreted with caution due to heterogeneity. So further vigorous and well-designed studies should be conducted to strengthen the evidence of the use of auricular acupuncture for obesity.

• 대한본초학회지
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• 제24권4호
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• pp.205-213
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• 2009

Objectives : Cancer incidence is increasing in all countries and chemotherapy-induced peripheral neuropathy (CIPN) in patients undergoing chemotherapeutic agents have been a clinically serious problems. So far therapeutic options for CIPN patients are limited and no confirmed methods have yet been established for dealing with peripheral neuropathy. Therefore this review is to provide an evidence-based summary of oriental medicine and CAM (complementary and alternative medicine) neuroprotective and treatment therapies which have gone through clinical trials. Methods : An overview of the domestic and international papers of adult clinical trials relating management of only CIPN symptoms through 1990 to present were searched by electronic databases. Search key words were chemotherapy-induced neurotoxicity, chemotherapy-induced peripheral neuropathy, chemotherapy toxicity & herb, chemotherapy toxicity & acupuncture, chemotherapy toxicity & CAM. Only English and Korean written papers were reviewed. Total 25 papers were reviewed in this study, 18 papers were retrieved by electronic search. Results : Clinical studies of managing CIPN were rare, two acupuncture clinical studies and four herb medicinal studies were found. Rest of 19 papers were about other CAM clinical studies. Total 25 papers were analyzed, and all interventions were focused on their pain control efficacy. Other 24 trials of potential therapies except one proved to be effective for CIPN, however some described to be inadequate positive or sufficient negative. Conclusions : As most of the studies were pilot studies, interventions for the prevention and treatment of CIPN have to go through prospective confirmatory studies, such as larger scale randomized, double-blinded, placebo controlled clinical trials must be done for the safe and effective use of proposed therapies. Also standard measurement scales have to be developed for the better clinical study of CIPN.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1661-1675
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• 2016

Objectives: Can addition of neurokinin-1 receptor antagonists (NK1-RAs) be considered as an ideal strategy for the prevention of chemotherapy-induced nausea and vomiting (CINV)? Researchers differ on this question. Materials and Methods: Electronic databases were searched for randomized control trials (RCTs) that evaluated the effectiveness and safety of NK1-RAs in preventing CINV. The primary end point was complete response (CR) in the acute, delayed, and overall phases after chemotherapy. Subgroup analyses evaluated the types of NK1-RAs, routines of administration, types of malignancies, regimens used in combination with NK1-RAs, and age of patients included in the studies. The incidences of different types of adverse events were also extracted to estimate the safety of NK1-RAs. Results: A total of 38 RCTs involving 13,923 patients were identified. The CR rate of patients receiving NK-RAs was significantly higher than patients in the control groups during overall phase (70.8% vs 56.0%, P<0.001), acute phase (85.1% vs 79.6%, P<0.001), and delayed phase (71.4% vs 58.2%, P<0.001). There were three studies including patients of children or adolescents, the CR rate was also significantly higher in the treatment group (overall phase: OR=2.807, P<0.001; acute phase: OR=2.863, P =0.012; delayed phase: OR=2.417, P<0.001). For all the other outcomes, patients in the NK1-RAs groups showed improvements compared to the control groups (incidence of nausea: 45.2% vs 45.9%, P<0.001; occurrence of vomiting: 22.6% vs 38.9%, P<0.001; usage of rescue drugs: 23.5% vs 34.1%, P<0.001). The pooled side effects from NK1-RAs did not significantly differ from previous reports and the toxicity rates in patients less than eighteen years old also did not diff between the two groups (P=0.497). However, we found that constipation and insomnia were more common in the patients of control groups, whereas diarrhea and hiccups were more frequently detected in patients receiving NK1-RAs. Conclusions: NK1-RAs improved the CR rate of CINV. They are effective for both adults and children. The use of NK1-RAs might be associated with the appearance of diarrhea and hiccups, while decreasing the possibility of constipation and insomnia.