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Efficacy of Herbal Medicine on Sleep Disorders in Parkinson's Disease: A Review of Randomized Controlled Trials (파킨슨병에 동반된 수면장애의 한약 치료에 대한 임상 연구 동향 : 무작위 대조연구를 중심으로)

  • Ji-hyeon Kang;Kyungmin Baek
    • The Journal of Internal Korean Medicine
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    • v.44 no.4
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    • pp.603-620
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    • 2023
  • Objectives: This study reviewed randomized controlled trials (RCTs) investigating the efficacy of herbal medicine on sleep disorders associated with Parkinson's disease and suggests a better research process. Methods: We searched for RCTs for herbal medicine treatments for sleep disorders related to Parkinson's disease on July 31, 2023 using eight databases (PubMed, Embase, the Cochrane library, China National Knowledge Infrastructure [CNKI], the Research Information Service System [RISS], Science ON, the Oriental Medicine Advanced Searching Integrated System [OASIS], and the Korea Citation Index [KCI]). Cochrane's risk of bias tool was used to assess the quality of the RCTs. Results: A total of 16 RCTs met all the inclusion criteria, and in most reports, the treatment group showed a significant improvement in sleep disorders compared to the control group. Total effective rate (TER), Pittsburgh Sleep Quality Index (PSQI), Unified Parkinson's Disease Rating Scale (UPDRS), TCM Symptom Score (TSS), Parkinson's Disease Sleep Scale (PDSS), etc., were used as evaluation indicators. Conclusion: Herbal medicine is a potential treatment for sleep disorders associated with Parkinson's disease. However, the selected RCTs were of poor quality, and it is necessary to perform more systematic studies.

A Case Study of A Patient Complaining of Disequilibrium Due to Proprioceptive Disorder (고유수용감각이상으로 인한 균형장애를 호소하는 환자 치험 1례)

  • Kyeong-Hwa Lee;Hye-Min Heo;Dong-Ju Kim;Hye-Jin Lee;Seung-Yeon Cho;Seong-Uk Park;Jung-Mi Park;Chang-Nam Ko
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.24 no.1
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    • pp.1-12
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    • 2023
  • ■Objectives This work reports the case of a patient complaining of disequilibrium due to proprioceptive disorder whose condition improved following Korean medicine treatment. ■Methods The patient was hospitalized for 15 days and treated with herbal medicine, mainly doinseunggi-tang-gami, and acupuncture, electroacupuncture, and moxibustion. Disequilibrium was clinically estimated using Korean dizziness handicap inventory(K-DHI) and the patient's subjective discomfort in this regard was also checked by numeral rating scale. The degree of improvement in blood stasis syndrome was evaluated using modified Blood Stasis Questionnaire II(modified BSQ-II) to assess the clinical effects of the treatment. ■Results After treatment, the K-DHI classification improved from severe to mild, and the patient's subjective discomfort was greatly improved from NRS 6 to NRS1. In addition, the degree of improvement in blood stasis syndrome improved from blood stasis group to blood stasis risk group compared to time of admission. ■Conclusion These results suggest that Korean medicine is effective in treating disequilibrium caused by proprioceptive disorder.

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Systematic Review and Meta-Analysis on Herbal Medicine for Generalized Anxiety Disorder: Focusing on Clinical Studies over the Past 5 Years (범불안장애의 한약 치료에 관한 체계적 문헌고찰 및 메타분석: 최근 5년 임상연구를 중심으로)

  • Min-Jae Kim;Hyun-Seob Park;Chan-Young Kwon
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.4
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    • pp.403-420
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    • 2023
  • Objectives: This study investigated the effectiveness of herbal medicine for generalized anxiety disorder (GAD) based on recent clinical studies. Methods: Studies were searched through four databases. Clinical research studies on herbal medicine treatment for GAD patients were included. The studies were analyzed according to study design, diagnostic criteria, population, and intervention. A risk of bias assessment was performed to assess the quality of the included randomized controlled trials (RCT). If the intervention applied to the treatment and control groups was the same and two or more studies were reporting the same items as outcome indicators, a meta-analysis was performed. Results: A total of 19 studies, including 12 RCTs were selected. The most common pattern identification was 'Phlegm fire disturbing upward' (痰熱上擾), and the most used herb for therapeutic purposes was 'Rhizome of Poria cocos' (茯苓). Meta-analysis results of three studies showed that there were no significant differences in effectiveness between the herbal medicine intervention and the Western medicine intervention. Meta-analysis results of five studies showed that the Hamilton Anxiety Rating Scale was significantly reduced in the case of herbal medicine intervention compared to Western medicine intervention. Conclusions: The results of our study demonstrated that herbal medicine treatment for GAD is effective in alleviating anxiety symptoms and chief symptoms of GAD. However, this study has several limitations; there was a lack of placebo-controlled RCT and an absence of objective diagnostic criteria in case reports. Therefore, further well-designed clinical studies, conducted based on the results of this study, are recommended.

The Effect of Gammaekdaejo-tang for Post-stroke Depression: A Systemic Review and Meta-Analysis (뇌졸중 후 우울증에 대한 감맥대조탕(甘麥大棗湯)의 효과 : 체계적 문헌 고찰 및 메타 분석)

  • Ye-seul Kim;Yeong-seo Lee;Young-kyun Kim;Kyoung-min Kim
    • The Journal of Internal Korean Medicine
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    • v.45 no.3
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    • pp.396-414
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    • 2024
  • Objective: This study assessed the effectiveness of Gammaekdaejo-tang for post-stroke depression through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: A search was conducted using keywords such as "Post-stroke Depression", "PSD", "Gammaekdaejo", and "Ganmai-dazao" on April 30, 2024. A meta-analysis was conducted according to outcome measurements, such as total effective rate (TER), HDRS (Hamilton Depression Rating Scale), and NIHSS (National Institute of Health Stroke Scale), using the Review Manager website. Results: A total of 10 RCTs was selected. The treatment group ((Gammaekdaejo-tang) or (Gammaekdaejo-tang combined with other ingredients or decoction)+Western medicine) showed significant improvement effects in terms of TER, HDRS, and NIHSS compared to the control group (Western medicine). [TER] RR: 1.19, 95% CI: 1.11 to 1.27, P<0.00001, RR: 1.24, 95% CI: 1.11 to 1.38, P<0.00001; [HDRS] MD: -2.29, 95% CI: -2.58 to -2.00, P<0.00001), MD: -3.28, 95% CI: -4.21 to -2.35, P<0.00001) [NIHSS] MD: -7.70, 95% CI: -8.52 to -6.89, P<0.00001. Conclusion: This study suggests that Gammaekdaejo-tang is effective in treating PSD. However, there are limitations, such as the small number of included studies, inability to clearly determine the effect of Gammaekdaejo-tang, inability to use various evaluation tools, and risk of bias. This research must be supplemented through systematic research design and implementation.

Psychiatric Factors Associated with Farmers' Syndrome (농부중의 정신적 원인에 대한 연구)

  • Park, Tae-Jin;Lee, Ka-Young
    • Journal of agricultural medicine and community health
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    • v.22 no.1
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    • pp.49-59
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    • 1997
  • Backgrounds : There has been many studies investigating the causes of farmers' syndrome. In some studies, psychologic stress is related to farmer's syndrome. And the diagnostic criteria of farmer's syndrome is similar to those of generalized anxiety disorder. So we carried out this study to investigate the psychiatric causes of farmers' syndrome. Methods : This study was done in some rural and urban areas of Kyoungsangnam Province, July, August, October and November of 1996. Those who came to free medical service and completed interview, medical examination and laboratory examination and 20-59 years old were 150 persons. And those who came to health center for health examination and completed only interview and 20-59 years old were 94 persons. The questionnaire was composed of sociodemographic factors, health risk factors, farmer's syndrome, work load, BEPSI(inventory to measure stress), Spielberger's state-trait anxiety inventory, self-rating depression scale. To examine statistical significance, we used X2-test, Mantel-Haenszel test for linear association, t-test, ANCOVA, correlation, multiple regression, logistic regression. Results : The prevalence of farmer's syndrome, adjusted for age and sex with population of Kyungsangnam Province of 1993 was 208 per 1,000(90 per 1,000 in men and 329 per 1,000 in women). In bivariate analysis, farmer's syndrome was significantly related to age, sex, job, income, smoking, alcohol drinking, work load, BEPSI, state anxiety, trait anxiety, depression, body mass index, Hwa-Byung, hypertension, anemia. However, when age and sex were adjusted, job was not significantly related to farmer's syndrome. The score of farmer's syndrome was significantly related to age, sex, work load, BEPSI, trait anxiety by multiple regression. Farmer's syndrome was significantly related to increasing age(odd ratio 1.079, 95% C.I. 1.060 - 1.099), sex(odds ratio of male 0.434, 95% C.I. 0.349 - 0.540), and BEPSI(odds ratio 1.231, 95% C.I. 1.148 - 1.320) by logistic regression. Results of logistic regression analysis of the component symptoms of farmer's syndrome were as follows. Shoulder stiffness was significantly related to increasing age, female sex and BEPSI. Lumbago was significantly related to increasing age, female sex and trait anxiety. Numb limbs and nocturia was significantly related to increasing age and female sex. Breathlessness was significantly related to work load, sleeplessness was significantly related to depression, dizziness was significantly related to job and state anxiety, and abdominal fullness was significantly related to female sex. Conclusion : Farmers' syndrome was related to work load, but was more related to psychiatric factors such as BEPSI and trait anxiety. And the occupation was not risk factor of farmers' syndrome in this study, so further study is needed to investigate the cause of farmers' syndrome.

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A Study of Facial Palsy Sequelae and Evaluating Scale (안면마비 후유증 및 평가 방법에 대한 고찰)

  • Lee, Jung-Woo;Kwon, Sin-Ae;Kim, Min-Jung;Song, Ji-Yeon;Kim, Pil-Kun;Seo, Byung-Kwan;Woo, Hyun-Su;Park, Dong-Suk;Baek, Yong-Hyeon
    • Journal of Acupuncture Research
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    • v.28 no.2
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    • pp.75-87
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    • 2011
  • Objectives : The purpose of this study is research on facial palsy sequelae and evaluating scale that have studied insufficiently until now. Methods : We researched on the symptoms, epidemiology and evaluating scale of facial palsy sequelae. For this, we searched the research papers on facial palsy sequelae and the clinical papers that find out the effect of treatment by evaluating facial palsy sequelae. Results : The symptoms of facial palsy sequelae are synkinesis, contracture, spasm, crocodile tears syndrome, tearing decrease, gustation impairment, hearing impairment, tinnitus, hyperacusis, etc. Among these, synkinesis, contracture, spasm and crocodile tears syndrome are the most frequently observed broadly. The poor prognosis factor of facial palsy can be the risk factor of facial palsy sequelae. For example, severe degeneration of facial nerve can be the risk factor of facial palsy sequelae. Most of clinical papers on facial palsy sequelae have used NRS(numeric rating scale) as evaluating scale. But NRS is very subjective scale. The scales of Stennert, Peitersen, Murata et al. can evaluate facial palsy sequelae grossly. Sunnybrook scale, Sydney scale, SAQ(synkinesis assessment questionnaire), the scale of Kim, the scale of Scott, HFS-7(hemi facial spasm), HFS-36 and Schirmer's test can evaluate the respective symptoms of facial palsy sequelae. Conclusions : The symptoms of facial palsy sequelae are synkinesis, contracture, spasm, crocodile tears syndrome, etc. Most of clinical papers on facial palsy sequelae have used NRS as evaluating scale. There were some scales that can evaluate facial palsy sequelae grossly and respectively. In future, we will need more progressed study of facial palsy sequelae and evaluating scale.

Comparative Analysis of Forest Fire Danger Rating on Accumulation Types of the Leaving of Thinning Slash (숲가꾸기 산물의 적재형태에 따른 산불위험성 비교 분석)

  • Lee, Si-Young;Lee, Myung-Woog;Lee, Hae-Pyeong
    • Fire Science and Engineering
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    • v.22 no.1
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    • pp.45-53
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    • 2008
  • The effect of thinned trees which are produced from forest thinning on forest fire was studied in this work. To investigate the effect of thinning slash, Yang-yang, In-je, and Ga-pyeong-gun were selected as thinning-areas and non-thinning areas. The research was carried out with the variations of tree's types, area's characteristics, thinning strength, thinning types, and pile types of thinned tree. The survey areas of 14 areas were selected at Yangyang-gun(5 areas), Gapyeong-gun(4 areas), and Inje-gun(5 areas), and on-the-spot investigations were carried out at the thinning areas of 9 and the non-thinning areas of 5, respectively. Non-thinning areas of 5, which are adjacent to thinning areas, were selected for the comparison with thinning areas and for the analysis of risk of forest fire. It is considered that forest fire have no chance to diffuse to a tree trunk because the height of thinned trees was lower than 1 m. However, it is considered that forest fire may affect directly to a tree trunk if it spread to piled thinned tree because there was no space between thinned trees and trees. Furthermore, it was found that re-ignition had a chance to occur due to lots of piled thinning trees.

The Associations of Percent Body Fat with Dietary Intake, Plasma Lipids, Lipoprotein(a), and PAI-1 in Middle Aged Korean Adults

  • Kim Rim, Jean-Chinock;Kang, Soon-Ah;Hiojung Wee
    • Korean Journal of Community Nutrition
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    • v.3 no.5
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    • pp.695-706
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    • 1998
  • This study was designed to investigate the associations of the percent body fat dietary intake, plasma lipoprotein profile, lipoprotein(a), and plasminogen activator inhibitor-1(PAI-1) concentrations of 1982 Korean subjects(men : 1000 and women : 982) between the ages of 40 and 59 years. The dietary assessment consisted of twenty-four hour dietary records and food frequency questionnaires. The subjects were identified into one of the five rating groups of % body fat : lean, underweight, normal, overweight and obese groups. The biochemical assessment included measurements of plasma total cholesterol(TC), HDL-cholesterol(HDL-C), LDL-cholesterol(LDL-C), triglyceride(TG), lipoprotein(a)(Lp(a)), and PAI-1. With respect to the ratio of percent energy intake of carbohydrate : protein : fat of the normal group of the women was 62% : 17% : 20%, respectively. Women apparently had a higher intake of carbohydrates than men(52% : 17 : 20%) did. There was a linear relationship between energy intake and % body fat in both mean and women(with the exception of the underweight group of women). The relationship of % body fat of men to the protein and fat intake was higher than that of the carbohydrate intake. Of the men in the study, intakes of energy, protein and alcohol were positively correlated to % body fat. In women, energy, carbohydrate and protein intake were positively correlated to % body fat, however, the fat, cholesterol and alcohol intake did not show any correlation to the % body fat in women. This study showed that % body fat was positively correlated with plasma TC, LDL-C, PAI-1 levels, and TG, but the % body fat was negatively correlated with plasma HDL-C level in both men and women. These results indicated that the high energy intake of obese or overweight subjects might contribute to several of the biochemical indices fo coronary heart disease(CHD) risk. In conclusion, increased energy intake is associated with overweight or obesity in middle aged Korean people. There was no relationship between % energy intake of fat and % body fat in the study, in middle-aged Korean men and women. The plasma lipid profile and PAI-1 level thought to be the risk factors of CHD were positively associated with percent body fat in middle aged Korean people.

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The Use of Satellite Image for Uncertainty Analysis in Flood Inundation Mapping (홍수범람도 불확실성 해석을 위한 인공위성사진의 활용)

  • Jung, Younghun;Ryu, Kwanghyun;Yi, Choongsung;Lee, Seung Oh
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.33 no.2
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    • pp.549-557
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    • 2013
  • An flood inundation map is able to convey spatial distribution of inundation to a decision maker for flood risk management. A roughness coefficient with unclear values and a discharge obtained from the stage-discharge rating equation are key sources of uncertainty in flood inundation mapping by using a hydraulic model. Also, the uncertainty analysis needs an observation for the flood inundation, and satellite images is useful to obtain spatial distribution of flood. Accordingly, the objective of this study is to quantify uncertainty arising roughness and discharge in flood inundation mapping by using a hydraulic model and a satellite image. To perform this, flood inundations were simulated by HEC-RAS and terrain analysis, and ISODATA (Iterative Self-Organizing Data Analysis) was used to classify waterbody from Landsat 5TM imagery. The classified waterbody was used as an observation to calculate F-statistic (likelihood measure) in GLUE (Generalized Likelihood Uncertainty Estimation). The results from GLUE show that flood inundation areas are 74.59 $km^2$ for lower 5 % uncertainty bound and 151.95 $km^2$ for upper 95% uncertainty bound, respectively. The quantification of uncertainty in flood inundation mapping will play a significant role in realizing the efficient flood risk management.

The Effect of Stellate Ganglion Block on Breast Cancer-Related Infectious Lymphedema (유방암 감염성 림프부종 환자에서 성상신경절 블록이 미치는 영향)

  • Lee, Youn Young;Park, Hahck Soo;Lee, Yeon Sil;Yoo, Seung Hee;Lee, Heeseung;Kim, Won Joong
    • Journal of Hospice and Palliative Care
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    • v.21 no.4
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    • pp.158-162
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    • 2018
  • Breast cancer related lymphedema (BCRL) is one of the most intractable complications after surgery. Patients suffer from physical impairment, as well as psychological depression. Moreover, a recent study revealed that cellulitis significantly increased the risk of BCRL, and cellulitis has been suggested as a risk factor of BCRL development. We describe a patient treated with stellate ganglion blocks (SGBs) without steroid for relief of symptoms and reduction of the arm circumference of breast cancer-related infectious lymphedema in a month. We measured the arm circumference at four locations; 10 cm and 5 cm above and below the elbow crease, numeric rating scale (NRS) score, lymphedema and breast cancer questionnaire (LBCQ) score on every visit to the pain clinic. A serial decrease of the arm circumference and pain score were observed after second injection. In the middle of the process, cellulitis recurred, we performed successive SGBs to treat infectious lymphedema. The patient was satisfied with the relieved pain and swelling, especially with improved shoulder range of motion as it contributes to better quality of life. This case describes the effects of SGB for infectious BCRL patients. SGB could be an alternative or ancillary treatment for infectious BCRL patients.