• Title/Summary/Keyword: Trials

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Paradigm Shift in Intra-Arterial Mechanical Thrombectomy for Acute Ischemic Stroke : A Review of Randomized Controlled Trials after 2015

  • Sheen, Jae Jon;Kim, Young Woo
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.427-432
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    • 2020
  • Three randomized control trials (RCTs), published in 2013, investigated efficacy of mechanical thrombectomy in large vessel occlusions and did not show better results compared to intravenous (IV) recombinant tissue-type plasminogen activator (tPA) alone. However, most clinicians treating stroke consider mechanical thrombectomy as the standard treatment rather than using IV tPA alone. This paradigm shift was based on five RCTs investigating efficacy of mechanical thrombectomy in acute ischemic stroke conducted from 2010 to 2015. They demonstrated that mechanical thrombectomy was effective and safe in acute ischemic stroke with anterior circulation occlusion when performed within 6 hours of stroke onset. There are four reasons underlying the different results observed between the trials conducted in 2013 and 2015. First, the three RCTs of 2013 used low-efficiency thrombectomy devices. Second, the three RCTs used insufficient image selection criteria. Third, following the initial presentation at the hospital, reperfusion treatment required a long time. Fourth, the three RCTs showed a low rate of successful recanalization. Time is the most important factor in the treatment of acute ischemic stroke. However, current trends utilize advanced imaging techniques, such as diffusion-weighted imaging and multi-channel computer tomographic perfusion, to facilitate the detection of core infarction, penumbra, and collateral flows. These efforts demonstrate that patient selection may overcome the barriers of time in specific cases.

The Meta-Analysis of the Effect of Acupressure for Nausea and Vomiting in Cancer Patients Receiving Chemotherapy (지압이 항암요법환자의 오심과 구토에 미치는 효과 관련 연구 분석)

  • Jang, Soon-Yang;Park, Jeong-Sook
    • Asian Oncology Nursing
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    • v.11 no.2
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    • pp.116-126
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    • 2011
  • Purpose: This study was to analyze the characteristics and effect size of intervention studies that used acupressure for the control of chemotherapy-induced nausea and vomiting (CINV). Methods: Nine electronic databases including Korea Education Research and Information, the National Assembly Library, KISS, Korea Med, NDSL, PubMed, EBSCO, Cochrane library, and OVID (to December, 2009) were searched. Thirteen studies of randomized controlled trials (RCTs) or controlled clinical trials (CCTs) were selected. Data were analyzed by SPSS/WIN 18.0. Results: Overall effect size of acupressure was moderate (0.684). Nausea had a moderate effect size (0.770) and nausea and vomiting had a high effect size (0.899). Acupressure using sticker needles had a high effect size (1.368) among finger acupressure, si-acupuncture, and wrist band treatment. Conclusion: This study suggests that acupressure using sticker needles on the spots of nei-guan, chok-samni and hap-kok can reduce the levels of nausea and vomiting in cancer patients receiving chemotherapy. For improving the reliability of the meta-analysis results, further randomized controlled trials with better study methodology are needed.

The Effect of Acupuncture combined with Conventional Rehabilitation Treatment for Cerebral palsy: A Systematic review of Randomized Controlled Trials(RCTs) (뇌성마비(Cerebral palsy) 소아의 재활치료와 재활과 침치료의 병행치료를 비교한 체계적 문헌 고찰)

  • Chang, Seok Joo;Seong, Eun Hak;Kim, Jang Hyun;Min, Sang Yeon
    • The Journal of Pediatrics of Korean Medicine
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    • v.34 no.3
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    • pp.81-96
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    • 2020
  • Objectives This study aims to evaluate the effect of acupuncture combined with rehabilitation treatment for cerebral palsy in children. Methods 7 electro-database (PubMed, CENTRAL, CNKI, DBpia, KISS, OASIS, KJTK) were searched for using the keywords "cerebral palsy AND acupuncture" which study is designed in randomized controlled trials (RCTs). Results 10 out of 303 studies were included in analysis after screened. Acupuncture combined with rehabilitation treatment had a significant effect on motor function. Only 1 study reported minor adverse effects. Conclusions All of the studies have shown acupuncture combined with conventional rehabilitation treatment was effective in cerebral palsy. Additional well-designed studies are needed to justify the effectiveness of acupuncture in cerebral palsy.

Maneuverability of a DWT 8,000-ton oil/chemical tanker by real sea trials - A comparison between the semi-balanced rudder and the flap rudder - (실선시험에 의한 DWT 8,000톤 선박의 조종성능 - Semi-balanced rudder and flap rudder -)

  • An, Young-Su;Lee, Hyeong-Geun;Park, Byung-Soo;Jang, Choong-Sik
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.51 no.2
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    • pp.257-264
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    • 2015
  • This study is intended to provide navigator with specific information necessary to assist the avoidance of collision and the operation of ships to evaluate the maneuverability of dead weight tonnage 8,000 tons Oil/Chemical tanker. The actual maneuvering characteristics of ship can be adequately judged from the results of typical ship trials. Author carried out sea trials based full scale for turning test, Z" maneuvering test, man overboard rescue maneuver test, inertia stopping test. Consequently, $2^{st}$ Overshoot yaw angle of the semi balanced rudder and flap rudder in ${\pm}20^{\circ}$ zig-zag test showed $22.2^{\circ}$ and $18.0^{\circ}$, respectively. The maneuverability of the vessel was good in the flap rudder. The man overboard rescue maneuver maneuverability test was most favorable in the flap rudder and the full load condition. The results from tests could be compared directly with the standards of maneuverability of IMO and consequently the maneuvering qualities of the ship is full satisfied with its.

A study on the turning ability of a DWT 8,000-ton oil/chemical tanker by real sea trials - A comparison between the semi-balanced rudder and the flap rudder - (실선시험에 의한 DWT 8,000톤 선박의 선회성능 - Semi-balanced rudder and flap rudder -)

  • Lee, Hyeong-Geun;An, Young-Su;Park, Byung-Soo;Jang, Choong-Sik
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.51 no.2
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    • pp.245-256
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    • 2015
  • This study is intended to provide navigator with specific information necessary to assist the avoidance of collision and the operation of ships to evaluate the maneuverability of dead weight tonnage 8,000 tons Oil/Chemical tanker. The actual maneuvering characteristics of ship can be adequately judged from the results of typical ship trials. Author carried out sea trials based full scale for turning test in ballast condition and full load condition, semi balanced rudder and flap rudder. The turning circle maneuvering were performed on the starboard and port sides with $35^{\circ}$ rudder angle at the normal continuous rating. The results from tests could be compared directly with the standards of maneuverability of IMO and consequently the maneuvering qualities of the ship is full satisfied with its.

Meta-Analysis of Constraint-Induced Movement Therapy in Hemiplegic Stroke Patient in Korea (국내 뇌졸중 편마비 환자를 대상으로 한 건측억제-환측유도 치료효과의 메타분석)

  • Park, So-Yeon;Shin, In-Soo
    • Physical Therapy Korea
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    • v.19 no.2
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    • pp.59-68
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    • 2012
  • This meta-analysis investigated the effects on arm motor impairment, arm motor function and disability, and psychological aspects of constraint-induced movement therapy (CIMT) for upper extremity hemiparesis following stroke, based on Korean studies. A comprehensive search of the complete Korean studies information service system (KISS), Research Information Sharing Service (RISS), Korea National Library, and the Korean Medical Database to September 2011 was conducted. Eleven eligible controlled clinical trials compared CIMT to a control group or an alternative treatment. All outcome measures of arm motor impairment, arm motor function and disability, and psychological aspects were pooled for calculating effect size. The overall effect size of CIMT was .700 (95% confidence interval=.482~.918). The CIMT programs showed large effect on the aspect of arm motor function and disability (the effect size is .920) and the psychological aspect (the effect size is .946). The effect of CIMT on arm motor impairment was moderate (the effect size is .588). These results show that CIMT may improve upper extremity motor impairment, function and disability, and psychological aspects following stroke. However, these results were based on a small number of studies, and not all of them were randomized control trials. Additional research is needed to include larger well-designed trials to resolve these uncertainties.

The Effect of Manual Stretching and Positioning and Developmental Treatment in Congenital Muscular Torticollis: randomized Controlled Trials (선천성 근성 사경 환아에서 수기신장과 자세와 발달을 이용한 치료의 효과에 대한 무작위 연구)

  • Lee, In-Hee
    • Physical Therapy Korea
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    • v.16 no.1
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    • pp.34-41
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    • 2009
  • The purpose of this study is to compare the outcomes of manual stretching treatment with those of motor development and positioning physical therapy (MDPPT) for congenital muscular torticollis (CMT). This study was designed to be randomized controlled trials and to evaluate the outcomes of 43 consecutive patients with CMT who were first seen when they were average 26 days old. Before treatments, the patients were unintentionallv classified into two clinical groups along with the treatment methods. Among the 43 patients, 22 were classified to the manual stretching group and 21 to the MDPPT group. By means of independent t-test on the result. the duration of treatment according to methods was not significantly different in two groups (p>.05). The duration of treatment in accordance with head tilt level was not significantly different in two groups (p>.05). There was change of mass diameter, between at the beginning day of treatment and after treatment in manual stretching group with a strong positive linear correlation (p=.000, r=.734), but slightly positive linear correlation in MDPPT group. The result of this study indicates that two therapeutic methods make little difference in effectiveness.

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Traditional Herbal Medicine for Dysfunctional Uterine Bleeding versus Western Medicine: A Systematic Review of Randomized Controlled Trials (기능성 자궁출혈에 대한 한약치료 : 체계적 문헌 고찰)

  • Park, Eo-Jin;Jo, Hee-Geun;Choi, Ji-Hyun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.4
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    • pp.110-127
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    • 2018
  • Objectives: To evaluate the effectiveness and safety of traditional herbal medicine (THM) in the treatment of dysfunctional uterine bleeding (DUB) versus conventional western medicine. Methods: Randomized Controlled Trials (RCTs) comparing THM vs. conventional western medicine for DUB, were obtained from PubMed, Cochrane Library, Embase, CNKI, RISS, NDSL, KISS and OASIS. The risk of bias was assessed by using Cochrane's risk of bias tool. Results: 16 RCTs with 1,659 patients were identified and reviewed. 10 RCTs reported THM was statistically effective than control group in effective rate. Also recurrent rate was estimated in 6 RCTs and was lower than control group. 7 studies observed adverse events (AEs) and severe AEs were not reported. Conclusions: Despite several limitations, this review suggested that THM was safe and effective in the treatment of DUB. THM may also decrease the recurrence rate. However, this could not be proven conclusively. To ensure evidence-based clinical practice, more sternly designed trials are warranted.

Trend for Acupuncture treatment Clinical Trial on Atopic Dermatitis (아토피피부염의 침 치료 임상연구 동향)

  • Park, Soo-Yeon;Choi, Jung-Hwa;Jeong, Min-Yeong;Lee, Gi-Hyun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.33 no.1
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    • pp.45-55
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    • 2020
  • Objectives : The objective of this study is to review the Trend of clinical trials conducted with the acupuncture treatment on Atopic Dermatitis. Methods : Through 4 foreign online databases(PubMed, Cochrane library, EMBASE, CNKI) and 3 domestic online databases(NDSL, RISS, OASIS), we searched for clinical studies performed acupuncture treatment for Atopic Dermatitis from 2010 to December 2019. Only randomized controlled trials(RCT) was selected and anlayzed according to the research method. Results : A total 4 studies were reviewed. LI11, ST36, SP10 were most frequently used acupoints in acupuncture treatment. Among the evaluation indexes, SCORAD, VAS, DLQI were used most. In most of the 4 studies, acupuncture treatment showed significant therapeutic effects. Conclusions : These results suggest that it is necessary to develop more detailed standards about Acupuncture treatment method as the method of acupuncture is getting more diverse, and objective tools are needed in evaluating Atopic Dermatitis.

Sex differences in repeatability of measurement for hamstring strength during maximal voluntary contractions (최대 수의적 수축 동안 뒤넙다리근 근력 반복성의 남녀 차이)

  • Lim, Woo Taek
    • Journal of Korean Physical Therapy Science
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    • v.27 no.1
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    • pp.9-17
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    • 2020
  • Background: This study aimed to examine the repeatability of hamstring strength during maximal voluntary contractions (MVCs) and to examine the sex difference. Design: Quasi-experiment design. Methods: The study recruited 23 healthy young individuals as participants. Hamstring flexibility was measured before and after MVCs by active knee extension test. Five trials of MVCs were performed, and hip extension forces were measured using a strain gauge during MVCs. Repeatability was confirmed by intraclass correlation coefficient (ICC) and coefficient of variation, and the difference between male and female participants was confirmed by independent samples t-test. Results: The forces measured during MVCs were significantly different between men and women over five trials. We observed the minimum and maximum force production at the first and fifth trial of MVCs in both men and women. Excellent to moderate reliability of the hamstring strength during MVCs was found in men (ICC range, 0.70-0.98) and women (ICC range, 0.66-0.90). There was no significant difference in hamstring flexibility between men and women. Conclusion: In clinical settings, we recommend excluding the first trial of MVCs in both men and women. Additionally, performing at least three trials of MVCs would be useful to improve the reliability of the baseline measures in women.