• Title/Summary/Keyword: Systemic review

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Topiramate for the Treatment of Binge Eating Disorder or Bulimia Nervosa : A Systemic Review of Human Clinical Studies and Case Reports (Topiramate의 신경성 폭식증 치료효과: 국내외 보고된 임상연구결과 및 치험사례 중심으로)

  • Lee, Yu-Jeung;Bang, Joon-Seok
    • Korean Journal of Clinical Pharmacy
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    • v.17 no.1
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    • pp.6-12
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    • 2007
  • The clinical investigations above suggest that topiramate may be an effective agent in the treatment of BED or BN by reducing binging/purging episodes, improving the HRQOL, and decreasing weight. The case report and case series also support these findings. However, there are several limitations in the above studies and cases. All these had relatively small sample size, and two of them were only 10-week-period studies. Optimal duration of treatment with topiramate in patients with BED or BN is unknown. As most clinicians treat the patient with BED or BN for 6 to 12 months and then reassess, at least 6 months period is needed to show its efficacy. One of studies included only women in the patient group. In the case series, all patients had severe comorbid mood disorders such as major depression and bipolar disorder besides BN. Therefore, notwithstanding its clinical usefulness, additional researches are needed to define the role and the benefits of topiramate in the treatment of BED or BN more thoroughly.

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Two Cases of Acute Respiratory Distress Syndrome with Pulmonary Hemorrhage Induced by Injection of Silicone at Perineum (외음부의 실리콘액 주사에 의한 폐출혈 및 급성 호흡 곤란 증후군 2예)

  • Kang, So-Eun;Yong, Suk-Joong;Lee, Won-Yeon;Shin, Pyo-Jin;Kim, Mi-Hae;Park, Hark-Cheon;Shim, Myung-Sook;Choi, Hyun-Min;Shin, Kye-Chul;Lim, Mi-Ae;Yang, Kyung-Moo
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.2
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    • pp.166-172
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    • 2001
  • Silicone fluid is a biomaterial widely used in modern cosmetic procedures because there are few side effects, considerable chemical stability and predictable physical properties. However, many local and systemic adverse reactions have reported. In particular some serious pulmonary complications have been reported such as pulmonary thromboembolism, acute respiratory distress syndrome with some cases leading to mortality. Most of the serious complicated cases were induced by an illegal silicone fluid injection. We experienced two cases of acute respiratory distress syndrome with pulmonary hemorrhage induced by an illegal silicone fluid injection. The patients were 41 & 51 year old women, who complained of dyspnea. The chest X-ray and HRCT scan findings showed a bilateral ground glass attenuation on the bilateral dependent portion of the upper and middle lung zone. The patients clinical symptoms and the radiologic and other laboratory findings were compatible with acute respiratory distress syndrome induced by the silicon fluid injection. Here we report two cases of acute respiratory distress syndrome with pulmonary hemorrhage induced by an illegal silicone injection with a review of the relevant literature.

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A discursive approach to analysis of definition of graph in first year middle school textbooks (담론적 관점(discursive approach)에서 중1 수학 교과서의 그래프 정의 분석)

  • Kim, Won;Choi, Sang-Ho;Kim, Dong-Joong
    • Communications of Mathematical Education
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    • v.32 no.3
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    • pp.407-433
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    • 2018
  • In order to analyze textbooks from a discursive approach, the purpose of this study is to structuralize an analytic framework based on previous literature review and apply it to analyzing the meanings and their syntheses developed by words and visual mediators appeared in the definition of graph in first-year middle school textbooks. The discursive approach consists of the communicational approach developed by Sfard(2008) and the systemic functional linguistics developed by Halliday(1985/2004). In this study, ideational meta-functions for ideational meanings and interpersonal meta-functions for interpersonal meanings were employed to analyze the meanings produced by words and visual mediators in textbooks, whereas textual meta-functions for textual meanings were used for analyzing the synthesized relationships between words and visual mediators. Results show that first, density in mathematical discourse was very high and subjects in mathematical activities were ambiguous in the ideational meanings of words, and behavior aspect was more emphasized than thinking aspect in the interpersonal meanings of words which request student participations. In the case of ideational meanings of visual mediators, there was a lack of narrative diagrams, whereas there were qualitative differences in the case of offer. Second, there was a need for promoting a wide range of diverse synthetic relationships between words and visual mediators for developing enriched mathematical meanings through the varying uses like specification, explanation, similarity, and complement. These results are so important that they provide a new analytic framework from a discursive approach to textbook analysis because not only words, but also visual mediators are analyzed as tools for producing meanings in mathematics textbooks and their synthetic relationships are also examined.

Establishment of the Korean Tolerable Daily Intake of Bisphenol A Based on Risk Assessments by an Expert Committee

  • Choi, Chan-Woong;Jeong, Ji-Yoon;Hwang, Myung-Sil;Jung, Ki-Kyung;Lee, Kwang-Ho;Lee, Hyo-Min
    • Toxicological Research
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    • v.26 no.4
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    • pp.285-291
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    • 2010
  • Recently, reproductive and neurobehavioral effects of bisphenol A (BPA) have been documented, and thus a review was requested for BPA management direction by the government. Therefore, this study was performed to establish a Korean tolerable daily intake (TDI) for BPA. An expert committee, consisting of specialists in fields such as toxicology, medicine, pharmacology, and statistics, was asked to evaluate BPA health based guidance values (HbGVs). Although many toxicological studies were reviewed to select a point of departure (POD) for TDI, rat and mouse reproductive studies by Tyl et al. (2002, 2006), which were performed according to GLP standards and OECD guidelines, were selected. This POD was the lowest value determined from the most sensitive toxicological test. The POD, a NOAEL of 5 mg/kg bw/day, was selected based on its systemic toxicity as critical effects. An uncertainty factor of 100 including interspecies and intraspecies differences was applied to calculate the TDI. According to the evaluation results, a TDI of BPA for Korean was suggested at 0.05 mg/kg bw/day. In addition, the BPA exposure level based on food consumption by the Korean population was estimated as 1.509 ${\mu}g/kg$ bw/day, and the HI was evaluated at 0.03 when the TDI of 0.05 mg/kg bw/day was applied. This HI value of 0.03 indicated that hazardous effects would not be expected from BPA oral exposures. Although highly uncertain, further studies on low dose neurobehavioral effects of BPA should be performed. In addition, it is recommended that the 'as low as reasonably achievable' (ALARA) principle be applied for BPA exposure from food packaging materials in newborn infants and children.

Assessment Instruments for Disaster Behavioral Health (재난정신건강 평가도구)

  • Park, Joo Eon;Kang, Suk-Hoon;Won, Sung-Doo;Roh, Daeyoung;Kim, Won-Hyoung
    • Anxiety and mood
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    • v.11 no.2
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    • pp.91-105
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    • 2015
  • Objectives : After disaster, some people develop posttraumatic stress sequelae such as posttraumatic stress disorder (PTSD), major depression, substance use disorders, and suicide. To date, numerous screening and assessment tools for behavioral health issues including mental health problems, psychosocial maladjustment and status of recovery after disaster have been developed. In this condition, one of important topics is to choose instruments that can quickly and accurately measure the issues. Methods : This article reviewed several self-reported scales in adults for disaster behavioral health, which were searched using academic search engines like PubMed, Scopus, KoreaMed and KISS from the earliest available date of indexing through January 31, 2015. Results : More than 40 eligible instruments evaluating the disaster behavioral health issues containing posttraumatic stress sequelae, psychological and social resources, non-disaster stress, and general functions were presented in terms of availability, effectiveness, and expeditiousness. Also, we introduced basic frame aiming on practical usage, which includes standard version and brief version of the instruments for disaster behavioral health. Conclusion : We suggest the accessibility and the applicability of assessment instruments for disaster behavioral health. The systemic review of this article will provide further directions for them.

Neuroendocrine Carcinoma of the Stomach -A Clinicopathologic Study of 18 Cases- (위에 발생한 신경내분비 암종 -18예의 위신경내분비 암종의 임상병리학적 고찰-)

  • Kim Byung Sik;Shin Dong Gyeu;Jang Se Jin;Choi Won Yong;Kim Yong Jin;Yook Jung Hwan;Oh Sung Tae
    • Journal of Gastric Cancer
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    • v.3 no.4
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    • pp.191-194
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    • 2003
  • Purpose: Neuroendocrine carcinomas of the stomach account for only about $0.3\%$ of all gastric tumors. The prognosis of this disease is very poor compared with the common type of gastric adenocarcinoma. The purpose of this retrospective study was to review the clinicopathologic features of 18 cases of this unusual gastric tumor and to establish a treatment strategy for this tumor. Materials and Methods: Excluding 2 cases of non-curative resection and 1 case of operative mortality, 18 cases of typical neuroendocrine carcinoma who had curative resection from January 1991 to December 2000 at Asan Medical Center were analyzed; 6841 gastric cancer patient were treated surgically during the same period. Results: The mean age at the time of diagnosis was 58.6 years (range: $35\∼75$ yr). Sixteen patients were male, and two were female. Eleven tumors ($61.1\%$) developed in the lower part of the stomach, three ($16.7\%$) in the middle part, and three ($16.7\%$) in the upper part. One tumor involved the entire stomach. Eight cases ($44.4\%$) were Borrmann type 2, and six case ($33.3\%$) were Borrmann type 3. The mean tumor size was 6.94 cm (range: $0.6\∼15$ cm). Nine cases ($50\%$) showed recurrence of the disease, and eight of them died within 20 months. Of the nine recurred cases, 7 cases ($77.8\%$) showed liver metastasis. The mean disease-free interval was 6.8 months (range: $2.5\∼11$ months) after surgical resection, and the mean survival was 17.9 months (range: $8\∼40$ months) for recurrence cases. One patient with liver metastasis was treated with a liver-wedge resection just after diagnosis and was still alive for 37.5 months postoperatively. There were 9 deaths after the median follow- up period of 40 months (range: $8\∼72$ months). Conclusion: Gastric neuroendocrine carcinomas frequently recur at the liver, even in early stage cancer, and have a poor prognosis. We experienced a case of successful control of hepatic metastasis by surgical resection and a case of a small cell carcinoma which was successfully controlled with systemic chemotherapy.

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P53 Arg72Pro Polymorphism and Bladder Cancer Risk - Meta-analysis Evidence for a Link in Asians but not Caucasians

  • Xu, Ting;Xu, Zi-Cheng;Zou, Qin;Yu, Bin;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2349-2354
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    • 2012
  • Objective: Individual studies of the associations between P53 codon 72 polymorphism (rs1042522) and bladder cancer susceptibility have shown inconclusive results. To derive a more precise estimation of the relationship, we performed this systemic review and meta-analysis based on 15 publications. Methods: We used odds ratios (ORs) with 95% confidence intervals (CIs) to assess the strength of the association. Results: We found that there was no association between P53 codon 72 polymorphism and bladder cancer risk in the comparisons of Pro/Pro vs Arg/Arg; Pro/Arg vs. Arg/Arg; Pro/Pro plus Pro/Arg vs. Arg/Arg; Arg/Arg vs. Pro/Arg plus Arg/Arg (OR=1.06 95%CI 0.81-1.39; OR=1.06 95%CI 0.83-1.36; OR=0.98 95%CI 0.78-1.23; OR=1.06 95%CI 0.84-1.32). However, a significantly increased risk of bladder cancer was found among Asians in the homozygote comparison (Pro/Pro vs. Arg/Arg, OR=1.36 95%CI 1.05-1.75, P=0.790 for heterogeneity) and the dominant model (Arg/Pro plus Pro/Pro vs. Arg/Arg, OR=1.26 95%CI 1.05-1.52, P=0.564 for heterogeneity). In contrast, no evidence of an association between bladder cancer risk and P53 genotype was observed among Caucasian population in any genetic model. When stratifying for the stage of bladder, no statistical association were found (Pro/Pro vs. Arg/Arg, OR=0.45 95%CI 0.17-1.21; Pro/Arg vs. Arg/Arg, OR=0.60 95%CI 0.28-1.27; Dominant model, OR=0.56 95%CI 0.26-1.20; Recessive model, OR=0.62 95%CI0.35-1.08) between P53 codon 72 polymorphism and bladder cancer in all comparisons. Conclusions: Despite the limitations, the results of the present meta-analysis suggest that, in the P53 codon 72, Pro/Pro type and dominant mode might increase the susceptibility to bladder cancer in Asians; and there are no association between genotype distribution and the stage of bladder cancer.

An Evaluation of Design Factors with Sidewalk Cafes for Street Revitalization (가로 활성화를 위한 가로변 노천카페의 유형별 설계요소 평가)

  • Kim, Dong-Chan;Choi, Woo-Young
    • Journal of the Korean Institute of Landscape Architecture
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    • v.41 no.2
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    • pp.47-58
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    • 2013
  • The purpose of this study is to categorize the types of sidewalk cafes, and to evaluate design factors with types of sidewalk cafes for street revitalization. Consequently, it may suggest efficient and systemic policies for the guidelines of sidewalk cafes. To ensure this end, the types of sidewalk cafes were categorized from the street relationship perspective by site investigation. A literature review and importance analysis were used to select the evaluation criteria, and the data were analyzed by statistic methods such as descriptive analysis and factor analysis. As a result, five main factors of the evaluation criteria were contracted: accessibility, aesthetics, identity, environmental, culturedness. Cumulative factor loading of these five factors was 68.731%, which was quite high. And the evaluation using the Likert scale was performed by 4 experts. Types of sidewalk cafes were categorized into 5 types: protruding, gating, blending stereoscopic, elevation angle, and sign provision from the street relationship perspective. On the evaluation by type, aesthetics and culturedness were the worst evaluated in the protruding type and the gating type, culturedness was the worst in the blending stereoscopic type, accessibility, aesthetics, culturedness were the worst in the elevation angle type, and accessibility, identity, culturedness were the worst in the sign provision type. On the evaluation by the indicators, culturedness was the worst evaluated, and on the evaluation by criteria, 'safety for impaired persons', 'interest of programs', 'openness of entrance' were the worst. It is recommended that a survey of importance-performance analysis focused on users be conducted.

The Domestic Trends of Korean Medicine Treatments on Traffic Accident for Recent 5 Years (최근 5년간 교통사고 후유증의 한의학적 치료에 대한 국내 연구 동향)

  • Choi, Young-Il;Kim, Min-Yeong;Choi, Hee-Seung;Jeong, Yun-Gyu;Ro, Hae-Rin;Kim, Se-Jun;Shin, Dong-Jae
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.8 no.1
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    • pp.27-38
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    • 2013
  • Objectives : The purpose of this study is to investigate the latest trends of korean Medicine treatments on traffic accident for recent 5 years. Methods : We investigated the studies on korean Medicine treatments for traffic accident via searching 6 Korean web databases. As a result, 65 research papers were found to be analyzed according to their published year, the titles of journals, the types of study, the number of cases, the sites of injury, the types of treatments the instruments for assessment and ethics approvals. Results : 65 articles were published since 2008. The studies on korean Medicine treatments about traffic accident were mainly published in Journal of Oriental Rehabilitation Medicine. 10 case studies, 14 case series, 11 non randomized controlled trials, 21 randomized controlled trials and 9 systemic reviews had been under research. The most frequently occurred symptoms were neck pain and low back pain. In most studies, various korean Medicine treatments were used to treat the symptoms. Visual analogue scale(VAS) and neck disability index(NDI) were used as primary assessments. In most clinical studies, there were no mention about approval of institutional review board(IRB). Conclusion : In this study, we analyzed the trends of korean Medicine treatments on traffic accident from 2008 to 2012. Reviewing the domestic trends of studies on korean Medicine treatments for traffic accident and examining the strong and weak points of those treatments are essential for the future studies. It is needed to adopt the qualitative methods of evaluation in order to develop a level of evidence.

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Case of Combined Acute Poststreptococcal Glomerulonephritis and Acute Invasive Meningococcal Disease (A군 연구균 감염 후 급성 사구체 신염과 동반된 침습성 수막구균감염증 1례)

  • Jeon, Hosang;Hahn, Wonho;Park, Dongkyun;Cha, Sungho
    • Pediatric Infection and Vaccine
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    • v.11 no.1
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    • pp.126-130
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    • 2004
  • Neisseria meningitidis is a leading cause of meningitis and septicemia in children and young adults. Meningococcemia, the most severe form of infection, represents a part of the various spectrum of the illness, and its clinical manifestations varied from mild fever and occult bacteriemia to fulminant catastrophic events(e.g., sepsis, shock, and death) within a few hours after onset of symptoms. Complement deficiencies, either congenital or acqired, increase the risk for invasive meningococcal disease. Since C3 plays a critical role in the complement cascade, congenital C3 deficiency or conditions that decrease C3(e.g., systemic lupus erythematosus, cirrhosis, nephritis, C3 nephritic factor) increase the risk for invasive disease due to pyogenic bacteria including N. meningitidis. We had experienced a case of meningococcemia and meningococcal meningitis presenting with mild fever, petechiae, and purpura. The patient was a 7-year old male. He had mild fever, vomiting, headache, nuchal rigidity, petechiae and purpura on both lower extremities, which spreaded to the whole body. His blood culture grew Neisseria meningitidis. The diagnosis of meningococcal meningitis was confirmed by examination of cerebrospinal fluid. The clinical symptoms of the illness were improved after treatment of antibiotics(cefotaxime) for 12 days. However the patient had developed generalized edema, microscopic hematuria & proteinuria on the third day after admission. High ASO titer and low serum C3 level were also noted. The microscopic hematuria returned to normal about 2 months after discharge. The C3 level returned to normal range about 3~4 months after discharge. we report a case of combined acute poststreptococcal glomerulonephritis and acute invasive meningococcal disease with reference review.

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