• 한국임상약학회지
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• 제20권3호
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• pp.183-192
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• 2010

While Self-monitoring of blood glucose (SMBG) has been recommended in some diabetes mellitus (DM) patients population according to the 2010 American Diabetes Association (ADA), 2007 Korean Diabetes Association (KDA), 2005 International Diabetes Federation guideline, it is excluded from a routine insurance coverage for outpatients in Korea. The objective of this study is to meta-analyze the impact of SMBG on HbA1c in non insulin-treated diabetes mellitus (NIT) DM patients. Published clinical literatures were identified through electronic database searches from inception and until May 2010. Studies were selected if they met the following inclusion criteria: 1) randomized controlled trials (RCTs), 2) comparing SMBG with non-SMBG in NIT type 2 diabetes, 3) measuring HbA1c as an outcome. Literature qualities were assessed by the Scottish Intercollegiate Guidelines Network Checklist. The mean difference of HbA1c between the 2 groups was pooled from non-heterogeneous 6 RCTs by meta-analysis using Review Manger (RevMan) Version 5.0 program. Pooled results demonstrated that SMBG is associated with a statistically significant improvement in glycemic control (mean HbA1c difference -0.23, 95%CI -0.32, -0.13). Sensitivity analysis showed that glycemic controls were significantly improved in patients with shorter study duration, more frequent self-monitoring, higher baseline HbA1c value, and without prior SMBG experiences. Conclusively SMBG is effective in improving glycemic control in NIT DM patients, but additional evidences from further researches in Korean patients and cost-effectiveness analysis would be necessary to make a suggestion for coverage expansion.

• 한국융합학회논문지
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• 제11권2호
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• pp.361-373
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• 2020

본 연구의 목적은 국내에서 혈액투석환자를 대상으로 적용된 스트레스 중재프로그램을 메타분석하여 스트레스 중재프로그램의 효과를 확인하고, 스트레스 중재 방법의 특성과 경향을 파악하기 위함이다. 분석대상연구는 총 10편으로 MINORS를 사용하여 문헌의 질평가를 실시하였으며, Comprehen sive Meta Analysis Version 3.0 및 Review manager version 5.3을 활용하여 자료를 분석하였다. 연구의 질 평가 점수는 21.2점이었으며, 중재프로그램의 심리적 스트레스에 대한 효과크기는 -.72, 생리적 스트레스 중 코티졸의 효과크기는 -.52로 보통의 효과를 보였다. 하위그룹 분석에서 음악요법, 아로마요법, 투석 중 중재, 개인중재, 1회당 60분 이상의 중재, 총 10~20회기 중재의 효과가 더 컸다. 본 연구 결과를 활용하여 추후 효과적인 스트레스 중재프로그램을 구성할 수 있을 것이며, 추후 혈액투석환자를 대상으로 한 무작위배정 실험연구가 더 필요하다.

• 보건교육건강증진학회지
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• 제32권4호
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• pp.37-46
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• 2015

Objectives: This study was conducted to expand evidence-base for the effectiveness of lifestyle intervention programs to prevent the onset of diabetes and cardiovascular diseases. Methods: Seven intervention studies between 2006 and 2014 at Korea Association of Health Promotion were analyzed. All the studies were randomized controlled trials(RCTs) and included multi-component behavioral interventions. The participants of the programs were 2,172 adults with risk factors regarding metabolic syndrome criteria. The proportions of normalized participants were compared within and across the studies using odds ratio effect sizes. Results: The reductions in the prevalence of metabolic syndrome were from 49.6% to 65.1% in intervention groups, and from 38.7% to 52.3% in comparison groups. Significant differences in effectiveness between groups were found in two studies, one in 2006 with odds ratio of 1.69(p<0.01) and another in 2009 with odds ratio of 2.36(p<0.001). Proportions of normalized participants were higher in blood pressure(31.9% to 52.5% in the intervention groups and 23.0% to 43.3% in comparison groups) than other risk factors. Abdominal obesity showed weakest improvement after the intervention in both groups. Conclusions: Lifestyle modification program is an effective method to reduce diabetes and cardiovascular risks in adults by decreasing the prevalence of metabolic syndrome and its components.

• 대한치과마취과학회지
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• 제12권2호
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• pp.99-104
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• 2012

Anticoagulation therapy with warfarin sodium is used to reduce the risk of thromboembolic events in patients with valvular heart disease, prosthetic heart valve, recurrent myocardiac infarction, etc. To keep anticoagulation state and minimize bleeding risk, patients with high risk of thromboembolism have been usually hospitalized for heparinization before oral surgery like extraction. However, this protocol requires time and high expense because of the long period of hospitalization and this is why low-molecular-weight heparin (LMWH) therapy is receiving attention in medical field as well as dentistry. LMWH has several advantages over unfractionated heparin (UFH) including predictable anticoagulant response which makes coagulation monitoring unnecessary in most patients and longer half-life than heparin which enables the patients to give themselves a subcutaneous injection once or twice daily. These advantages of LMWH make patients get oral surgery on an outpatient basis so that they can save time and cost. This case report introduces the use of LMWH in dental surgery and suggests proper use of LMWH. Though LMWH bridging therapy is widely used most of the previous studies are observational studies. Therefore randomized controlled trials are necessary to evaluate the safety and efficacy of LMWH bridging therapy.

• 한국융합학회논문지
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• 제9권6호
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• pp.347-355
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• 2018

본 연구는 우리나라 노인을 대상으로 시행된 웃음치료의 융합적 메타분석을 통해, 노인우울 감소 효과크기를 확인하고, 노인의 우울감소를 위한 웃음치료의 중재특성과 경향을 파악하기 위하여 실시된 융합적 연구이다. 10개의 데이터베이스 검색을 통해 확인한 486개 문헌 중 선정기준에 부합하는 20문헌을 최종 선정하였다. SIGN의 도구를 이용하여 문헌의 질평가를 시행하였으며 CMA 3.0을 활용하여 자료를 분석하였다. 노인우울에 대한 웃음치료의 전체효과크기는 중간크기로 나타났으며 (SMD=-0.57, 95% CI: -0.70~-0.44, p<.001), 작은 크기의 이질성을 보였다($I^2=18%$). 하위그룹 분석에서 재가노인, 통합군, 4-6주 중재군, 집단중재군의 효과가 더 컸다. 본 융합연구의 결과를 활용하여 효과적인 웃음치료 프로그램 구성을 도모할 수 있을 것이며, 추후 노인요양시설 노인을 대상으로 한 반복연구와 무작위배정 실험연구가 더 필요하다.

• Journal of Gastric Cancer
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• 제11권1호
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• pp.1-6
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• 2011

Gastric cancer is the most common malignancy and the incidence is steadily increasing in Korea. The principal treatment modality for gastric cancer is surgical extirpation of tumor along with draining lymph nodes. Gastrectomy with D2 lymph node dissection has been well established as a standard of surgery and improved the survival of gastric cancer patients. Recently, technological advances are drastically reshaping the landscape of surgical treatment of gastric cancer. One of the most notable trends is that minimal access surgery becomes dominating the treatment of early stage diseases. For advanced diseases, the standard access surgery is considered a reference treatment. Although there is a pilot study underway to evaluate the feasibility of the application of minimal access surgery to advanced gastric cancer (AGC), the evidence for oncological safety is not yet provided sufficiently. Based on the recent randomized controlled trials, the extent of surgery for AGC has re-defined as para-aortic lymph node dissection dose not add any survival benefit while increasing surgery-related morbidities. In addition, it is now accepted as a standard operation omitting unnecessary procedures such as splenectomy and/or distal pancreatectomy for prophylactic lymph node dissection. Conceptual and technical innovation has contributed to decreasing morbidity and mortality without impairing oncological safety. All these recent advances in the field of gastric cancer surgery would be concluded in maximizing therapeutic index for gastric cancer while improving quality of life.

• 중환자간호학회지
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• 제11권2호
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• pp.75-85
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• 2018

Purpose : The purpose of this study was to examine the possible direction of critical care nursing research in the future by analyzing the trends of recent Korean studies. Method : Using a database search, we selected 263 articles on critical care nursing that were published in Korean journals between 2008 and 2017. Then, we conducted an integrative review of the contents of the selected articles and analyzed the English abstracts using the relevant packages and functions of the R program. Results : The number of studies concerning critical care nursing has increased over the 10-year period, and the specific topic of each study has diversified according to the time at which it was conducted. In terms of quality, the majority of the research was published in high-level academic journals. The key words regularly studied over the past decade were: knowledge, delirium, education, restraint, stress, and infection. Studies related to vancomycin-resistant enterococci infection, compliance, and standards have decreased, while studies related to death, communication, and safety have increased. Conclusion : Randomized controlled trials and protocol research for evidence-based critical care need to be conducted, as does research on family involvement. The key word analysis of unstructured text used in this study is a relatively new method; it is suggested that this method be applied to various critical care nursing research and develop it methodologically.

• 대한한의학회지
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• 제27권3호
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• pp.151-168
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• 2006

Objectives: To help the Oriental medicine clinical studies for the common cold treatment, this study analyzed the tendency of research into complementary medicine on the common cold recently published in PubMed. Methods: This study analyzed 26 research papers on complementary medicine on the common cold published in PubMed Over the past 10 years. It measured annually and for each country the number of papers published, the number of subjects, the period of research, the area of trial, the method of study, the objective of study, and intervention, respectively and intervention, the objective of study, and the result of trials overall. Results: There were research papers concerning treatment, prevention, safety of herbal medicine, inducement, and improvement of symptoms of the common cold in the study objective the most among them concerned treatment of the common cold. There were more positive results compared to negative results for treatment and prevention. The results for safety and symptom improvement were positive, while the results for the inducement were indeterminate. There were research papers about using food and medicine, acupuncture, hydrotherapy, and cold exposure in intervention the most among them were about using food and medicine. The food and medicine interventions were Echinacea preparations, vitamins, zinc preparations, Baptisia, Thuja, the root of North American ginseng, probiotic bacteria, troxerutin, garlic, Andrographis paniculata, and caffeine. The use of Echinacea preparations was the most frequent among them. Conclusions: Recent research results of complementary medicine on the common cold were more positive than negative.

• 대한한의학회지
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• 제35권2호
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• pp.12-18
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• 2014

Objectives: This was a retrospective case series about the clinical effect of integrated approach with behavior therapy for obstructive sleep apnea (OSA). Methods: Medical records of twelve patients with OSA who were treated with behavior modification including nasal breathing with oral appliances and sleep in lateral position, oral administration of herbal medicines and acupuncture treatment between January and September of 2013 were reviewed. Apnea-hypopnea index (AHI), day time sleepiness, apneas and hypopneas counts during sleep, risk indicator (RI), oxygen desaturation index, average saturation during sleep, lowest desaturation, lowest saturation, snoring events ratio and number of desaturations (%) were assessed before and after treatments with the ApneaLink device, which is a portable diagnostic apparatus for monitoring airflows of the patient's breath at home. Results: After an average 62.67 (SD 37.16) days of treatment, AHI (from 17.67, 12.79 to 8.75, 8.25, p=0.007), RI (from 22.00, 13.26 to 12.09, 8.03, p=0.004), oxygen desaturation index (from 17.33, 12.17 to 8.17, 7.86, p=0.005), and number of desaturations (from 7.00 times, 9.79 to 0.92 times, 1.39, p=0.044) showed significant improvement. Daytime sleepiness improved from 6.5 (3.2) to 3.8 (1.8) but there was no significant difference after treatment (p=0.17). No adverse events related to treatment were observed during participation in the treatment. Conclusion: From this case series, we found that behavior modification with herbal medication and acupuncture may be effective for improving sleep apnea without serious adverse events. Future randomized controlled trials with larger sample size will be necessary for concrete evidence on the benefit of this integrated treatment for OSA.

• 척추신경추나의학회지
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• 제15권1호
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• pp.65-74
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• 2020

Objectives : This study aimed to evaluate the randomized controlled clinical trials (RCTs) analyzing the effectiveness of Chuna manual therapy (CMT) for benign prostatic hyperplasia (BPH). Methods : Among the literature published until May 2020, a literature search was carried out using 10 electronic databases using related keywords to identify all RCTs that applied CMT for the treatment of BPH. The Cochrane risk of bias tool was used to assess the methodological quality of each RCT. Results : Five RCTs met our inclusion criteria and were included in the analysis. These studies showed that CMT had no positive results compared to herbal medication. However, positive results were shown in terms of an increased efficacy rate, reduced international prostate symptom scores, and increased maximum flow rate when CMT was combined with acupuncture or herbal medication. Conclusions : Based on the analysis, this review has limited evidence of CMT being beneficial in the treatment of BPH. Therefore, further investigation is required using well-designed RCTs to support the effectiveness of CMT and to obtain higher evidence.