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A Systematic Review and Meta-Analysis of Herbal Medicine for Frozen Shoulder (동결견의 한약 치료에 대한 체계적 문헌고찰 및 메타분석)

  • Oh, Tae-Young;Kim, Yeon-Hee;Oh, Eun-Mi;Hong, Su-Min;Ha, Hyun-Ju;Lee, Eun-Jung;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.3
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    • pp.15-33
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    • 2019
  • Objectives The objective of this study is to provide the evidence of the effectivness of herbal medicine for frozen shoulder. Methods 2 Korean medical on-line databases (Oriental Medicine Advanced Searching Integrated System, Korean Traditional Knowledge), and 3 foreign databases (Pubmed, Cochrane library, China National Knowledge Infrastructure) were searched to find articles concerning herbal medicine for frozen shoulder. We selected randomized controlled trials (RCTs). Several repeated articles and those not relevant to the topic were excluded, as well as review articles and commentaries. The methodological quality of RCTs were evaluated using the Cochrane risk of bias tool and meta-analyes were perfomed. Results Total 474 studies were founded and 22 RCTs were selected for systematic review. Efficiency rate was used as the primary evaluation method. Almost studies reported that herbal medicine has significant effect on pain reduction, increasing shoulder function on frozen shoulder. 3 studies comparing herbal medicine and chuna with chuna and 3 studies comparing herbal medicine with ibuprofen were included in the meta-analysis. At herbal medicine and chuna with chuna meta-analysis, it showed positive results of herbal medicine for efficiency rate (risk ratio: 1.18, 95% confidence interval: 1.09-1.27, p<0.0001). At herbal medicine with ibuprofen medta-analysis, it showed positive results of herbal medicine for efficiency rate (risk ratio: 1.15, 95% confidence interval: 1.05-1.27, p=0.003). Conclusions The studies showed that herbal medicine can significantly effective on frozen shoulder. However, the risk of bias in RCTs were evaluated as uncertain. In the future, further well-designed RCTs are needed to prove the effectiveness of herbal medicine for frozen shoulder and reduce the risk of bias.

Levothyroxine Dose and Fracture Risk According to the Osteoporosis Status in Elderly Women

  • Ko, Young-Jin;Kim, Ji Young;Lee, Joongyub;Song, Hong-Ji;Kim, Ju-Young;Choi, Nam-Kyong;Park, Byung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.47 no.1
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    • pp.36-46
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    • 2014
  • Objectives: To evaluate the association between fracture risk and levothyroxine use in elderly women with hypothyroidism, according to previous osteoporosis history. Methods: We conducted a cohort study from the Korean Health Insurance Review and Assessment Service claims database from January 2005 to June 2006. The study population comprised women aged ${\geq}65$ years who had been diagnosed with hypothyroidism and prescribed levothyroxine monotherapy. We excluded patients who met any of the following criteria: previous fracture history, hyperthyroidism, thyroid cancer, or pituitary disorder; low levothyroxine adherence; or a follow-up period <90 days. We categorized the daily levothyroxine doses into 4 groups: ${\leq}50{\mu}g/d$, 51 to $100{\mu}g/d$, 101 to $150{\mu}g/d$, and > $150{\mu}g/d$. The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with the Cox proportional hazard model, and subgroup analyses were performed according to the osteoporosis history and osteoporosis-specific drug prescription status. Results: Among 11 155 cohort participants, 35.6% had previous histories of osteoporosis. The adjusted HR of fracture for the > $150{\mu}g/d$ group, compared with the 51 to $100{\mu}g/d$ group, was 1.56 (95% CI, 1.03 to 2.37) in osteoporosis subgroup. In the highly probable osteoporosis subgroup, restricted to patients who were concurrently prescribed osteoporosis-specific drugs, the adjusted HR of fracture for the > $150{\mu}g/d$ group, compared with the 51 to 100 ${\mu}g/d$ group, was 1.93 (95% CI, 1.14 to 3.26). Conclusions: While further studies are needed, physicians should be concerned about potential levothyroxine overtreatment in elderly osteoporosis patients.

A Study on the Usefulness of the BPO System - Focusing on Comparison with L/C System - (BPO 제도의 유용성에 관한 연구 -L/C 제도와의 비교를 중심으로-)

  • JANG, Eun-Hee;JEONG, Hee-Jin
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.73
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    • pp.21-42
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    • 2017
  • A BPO is an irrevocable undertaking given by an Obligor Bank acting on behalf of the buyer to a Recipient Bank acting on behalf of the seller to pay on satisfaction of certain specified conditions. There have been a Trade Service Utility(TSU), a Transaction Matching Application(TMA) and ISO 20022 TSMT messages that core electronic technical systems linked to the BPO. As a key usefulness of the BPO, it brings to market an alternative means of satisfying the risk mitigation, financing and information management needs of banks and businesses engaged in trade. That is, corporates can spread the risk among multiple Obligor Banks by requesting multiple BPOs for the same trade transaction not to exceed the value of the initial transaction. Since the BPO replaces the manual document checking process with the electronic matching of data, buyers and sellers will benefit from significantly increased accuracy and objectivity. By using BPO, buyers and sellers can become trusted counterparties by demonstrating reliability and giving sellers the assurance of being paid on time as per the payment terms and conditions agreed. When compared to L/C, the BPO requires submission of data only. This requires a change of practice of those accustomed to dealing with physical documentation. The beneficiary of a BPO is the Recipient Bank which is always the Seller's Bank. In the meantime, banks will need to agree between themselves that the URBPO 750 will be applied, modified or excluded. However, customers of banks will face low transactional costs due to a fully automated process and standardized data formats used in international trade documentation. There is no amendment and cancellation rules in the URBPO 750s, but only have Assignment of Proceeds rules. As a result, the BPO is likely to enable new business opportunities, lower costs, fast transaction process and strengthen key customer relationships.

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Radiation Exposure and Cancer Mortality Among Nuclear Power Plant Workers: a Meta-analysis (원전종사자의 방사선 노출과 암사망 위험도와의 관련성에 대한 메타분석)

  • Park, Eun-Sook;Moon, Ki-Eun;Kim, Han-Na;Lee, Won-Jin;Jin, Young-Woo
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.2
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    • pp.185-192
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    • 2010
  • Objectives: We conducted a meta-analysis to investigate the relationship between low external doses of ionizing radiation exposure and the risk of cancer mortality among nuclear power plant workers. Methods: We searched MEDLINE using key words related to low dose and cancer risk. The selected articles were restricted to those written in English from 1990 to January 2009. We excluded those studies with no fit to the selection criteria and we included the cited references in published articles to minimize publication bias. Through this process, a total of 11 epidemiologic studies were finally included. A publication bias was tested for using Egger's test. The homogeneity test was performed before the integration of each of the standardized mortality ratios (SMRs) and the result proved that the studies were heterogeneous. Results: We found significant decreased deaths from all cancers (SMR = 0.75, 95% CI = 0.62 - 0.90), all cancers excluding leukemia, solid cancer, mouth and pharynx, esophagus, stomach, rectum, liver and gallbladder, pancreas, lung, prostate, lymphopoietic and hematopoitic cancer. The findings of this meta-analysis were similar with those of the 15 Country Collaborative Study conducted by the International Agency for Research on Cancer. A publication bias was found only for liver and gallbladder cancer (p = 0.015). Heterogeneity was observed for all cancers, all cancers excluding leukemia, solid cancer, esophagus, colon and lung cancer. Conclusions: Our findings of low mortality for stomach, rectum, liver and gallbladder cancers may explained by the health worker effect. Yet further studies are needed to clarify the low SMR of cancers, for which there is no useful screening tool, in nuclear power plant workers.

Research Trends in Acupuncture Treatment of Internet Addiction Disorder (인터넷 중독에 대한 침 치료 연구동향)

  • Lee, Seung Hwan;Cho, Young Hun;Jeong, Bo Eun;Seong, Woo Yong;Lim, Jung Hwa
    • Journal of Oriental Neuropsychiatry
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    • v.28 no.1
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    • pp.1-13
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    • 2017
  • Objectives: The purpose of this study is to investigate the trends in acupuncture research on Internet addiction disorder. Methods: Clinical research papers on acupuncture treatment were searched and selected. Seven databases, including English, Chinese, Japanese, and Korean databases, were searched systematically. Non-clinical, non-acupuncture, and unpublished studies were excluded. The characteristics of the included articles were described, and these articles were assessed by the Risk of Bias (RoB) tool or the Risk of Bias Assessment for Non-randomized Studies (RoBANS) tool. Results: Ten clinical studies on Internet addiction disorder were finally selected, and all of these studies were published in China. The electroacupuncture (EA) method was used in most of the acupuncture treatment studies. Most of the psychotherapy studies used cognitive behavioral therapy (CBT) in the control group. Most of the studies showed effective results. The results of this study suggest that the combination of acupuncture and psychotherapy is more effective than either treatment modality alone. However, the quality of these clinical studies was low. Conclusions: According to this study, acupuncture treatment seems to have excellent effects in Internet addiction disorder. However, the quality of most studies was low. Therefore, higher quality research on Internet addiction disorder is required.

Results of Protocol-based Perioperative Management in Off-Pump Coronary Artery Bypass Grafting for Patients with Non-dialysis-dependent Chronic Kidney Disease

  • Kim, Jeong-Won;Sim, Hyung Tae;Yoo, Jae Suk;Kim, Dong Jin;Cho, Kwang Ree
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.427-434
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    • 2016
  • Background: Recent studies have demonstrated the benefits of off-pump coronary bypass grafting over the on-pump technique in patients with chronic kidney disease (CKD). To further reduce the risk of acute kidney injury and the need for renal replacement therapy, even in patients undergoing off-pump coronary artery bypass grafting, we adopted protocol-based perioperative management for patients with CKD. Methods: From December 2012 to March 2015, 265 patients underwent isolated off-pump coronary artery bypass grafting. To analyze renal function in a stable condition, we excluded 12 dialysis-dependent end stage renal failure and 10 emergency or urgent cases. Among the remaining 243 patients, 208 patients had normal kidney function (normal group), and 35 patients had CKD (CKD group). Minimizing contrast exposure, ensuring adequate hydration, using strict drug dosage adjustment, and optimizing hemodynamic status were key elements of the protocol for the CKD group. Results: The risk of acute kidney injury was about ${\times}3$ higher in the CKD group than in the normal group (p=0.01). Estimated glomerular filtration rates and serum creatinine levels deteriorated until the third postoperative day in the CKD group. However, by adopting protocol-based perioperative management, this transient renal dysfunction recovered to preoperative levels by the fifth postoperative day without requiring renal replacement therapy in all cases. Conclusion: Off-pump coronary bypass surgery combined with this protocol-based perioperative management strategy in patients with non-dialysis-dependent CKD could mostly be performed without renal replacement therapy.

Occupational Exposure to Trichloroethylene and Non-hodgkin Lymphoma Risk (직업적 트리클로로에틸렌 노출과 비호지킨림프종의 연관성)

  • Chun, Jae-Buhm;Han, So-Hee;Yoon, Hyung-Suk;Lee, Eun-Jung;Lee, Kyoung-Mu
    • Journal of Environmental Health Sciences
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    • v.37 no.5
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    • pp.358-368
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    • 2011
  • Objectives: In order to evaluate the association between occupational exposure to chloroethylene (TCE) and risk of non-Hodgkin lymphoma (NHL), we conducted a meta-analysis of retrospective cohort studies and casecontrol studies and attempted to summarize the evidence of the association from molecular-epidemiological studies and experiments with human cells. Methods: In the meta-analysis, we restricted the analysis to those studies with data for chlorinated solvents, degreasers, or TCE. Studies involving dry cleaners or launderers were excluded from the analysis because use of TCE as a dry cleaning fluid has been rare since the 1960s. The data were combined using a random-effects model to estimate the summary risks (OR and RR) and 95% confidence intervals (CIs). Molecular evidence of the effect of TCE on human immune system were also reviewed and summarized. Results: Occupational exposure to TCE was strongly associated with NHL among cohort studies (number of studies=13, summary RR=1.33, 95% CI=1.04-1.70) whereas the association was not statistically significant among case-control studies (number of studies=15, summary OR=1.10, 0.98-1.23). When exposure level was considered, it became statistically significant for the highest exposure level (number of studies=5, summary OR=1.70, 1.25-2.32). Molecular evidences showed that TCE exposure in human or cultured human cells may cause a significant decrease immune cell subsets and changes in hormone levels related to immune response. Conclusions: Our results from meta-analysis and additional molecular evidence suggest that occupational exposure to TCE may cause NHL. However, unmeasured potential confounding and unclear dose-response relationships warrant further study on the role of TCE exposure in NHL carcinogenesis.

Cervical Pathology in Cytology-Negative/HPV-Positive Women: Results from Lampang Cancer Hospital, Thailand

  • Paengchit, Kannika;Kietpeerakool, Chumnan;Wangchai, Warunee;Pouraeng, Saifon;Lalitwongsa, Somkiet
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7951-7954
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    • 2014
  • Background: To evaluate the cervical pathology of cytology-negative/high-risk human papillomavirus (HR-HPV) positive-women. Materials and Methods: This study recruited 4,583 women aged 30-70 years who had undergone cervical screening by liquid-based cytology and HR-HPV test (14 HR-HPV types) at Lampang Cancer Hospital during October 2012 to July 2013. Colposcopy was carried out in all women. Results: One hundred and ninety-two (4.19%) women were found to be cytology-negative/HR-HPV-positive. However, 23 cases were excluded because of incomplete information, leaving 169 women for further analyses. Of these 169, 45 (26.6%) were infected with HPV 16/18 and 49 (29.0%) with multiple genotypes of HR-HPV. Nineteen of 169 (11.24%) women were found to have CIN 2-3. No women in the present study had AIS or invasive cervical lesions. Prevalence of CIN 2-3 among women infected with HPV 16/18 was 15.6% which was higher than the 9.68% in those with non-HPV 16/18 oncogenic types. Conclusions: Overall, 11% of cytology-negative/HR-HPV-positive women had significant cervical lesions. Risk of harboring such lesions was substantially increased among those who were HPV 16/18 positive.

Influence of Mammographic Screening on Breast Cancer Incidence Trends in South Australia

  • Beckmann, Kerri Rose;Roder, David Murray;Hiller, Janet Esther;Farshid, Gelareh;Lynch, John William
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3105-3112
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    • 2014
  • Purpose: To examine breast cancer (BC) incidence trends in relation to mammographic screening and risk factor prevalence in South Australia (SA). Materials and Methods: Trends in annual BC incidence rates were calculated using direct standardisation and compared with projected incidence derived from Poisson regression analysis of pre-screening rates. Annual percentage change and change time points were estimated using Joinpoint software. Biennial mammography screening participation rates were calculated using data from BreastScreen SA. Trends in overweight/obesity, alcohol use and hormone replacement therapy (HRT) use were examined using 1991-2009 Health Omnibus Survey data. Trends in total fertility were examined using data from the Australian Bureau of Statistics. Results: BC incidence increased around the time BreastScreen commenced and then stabilised in the mid-1990s. However rates have remained higher than projected, even though the proportion and age distribution of first time screening attendees stabilised around 1998. A decrease in BC incidence was observed among women aged 50-59yrs from the late-1990's but not among older women. Obesity and alcohol use have increased steadily in all age groups, while HRT use declined sharply from the late-1990s. Conclusions: BC incidence has remained higher than projected since mammography screening began. The sustained elevation is likely to be due to lead time effects, though over-diagnosis cannot be excluded. Declining HRT use has also impacted incidence trends. Implications: Studies using individual level data, which can account for changes in risk factor prevalence and lead time effects, are required to evaluate 'over-diagnosis' due to screening.

A Review on Clinical Studies of Acupuncture and Moxibustion Therapy for Acute Herpes Zoster (급성기 대상포진의 침구치료에 대한 임상 연구 문헌 고찰)

  • Choi, Yoo Min;Kim, Seok Hee;Kim, Ju Yong;Park, Sang Hun;Yook, Tae Han;Kim, Jong Uk
    • Journal of Acupuncture Research
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    • v.32 no.3
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    • pp.147-161
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    • 2015
  • Objectives : The purpose of this study was to review the effectiveness of acupuncture and moxibustion therapy for the treatment of acute herpes zoster. Methods : Data was collected by two researchers. Clinical trials on PubMed were retrieved using MeSH terms including "herpes zoster" combined with "acupuncture therapy", "moxibustion", "bloodletting", "electroacupuncture", and related keywords. We excluded irrelevant studies and included randomized and non-randomized controlled trials, case series and case reports. Finally, we selected a total of thirteen studies and conducted a literature analysis and an object quality assessment. Results : Twelve of thirteen studies were about acupuncture and moxibustion combined therapy. Only one study suggested that a single acupuncture therapy is expected to be equally as effective as a common western medicine therapy. There was some evidence related to the effectiveness of moxibustion, venesection and electroacupuncture, but it dealt with combining therapy and was insufficient, and with an inclusion of potential risk factors. Only one study was conducted under approval from an institutional review board. No severe treatment-related adverse events were observed. A quality assessment suggested that there was some weakness in the areas of blinding and concealment. Conclusions : There is some evidence that suggests the effectiveness and safety of acupuncture and moxibustion combined therapy as a treatment for acute herpes zoster.