• Korean Journal of Clinical Pharmacy
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• v.29 no.2
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• pp.115-124
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• 2019

The purpose of this systematic review and meta-analysis was to assess the preventive effect of theophylline on acute kidney injury and the ameliorative effect of theophylline on renal function in asphyxiated neonates. A literature search of the PubMed/Medline, Embase, and Cochrane Library databases for information published up to February 2019 was conducted. All studies that reported the incidence rate of acute kidney injury, serum creatinine level, and glomerular filtration rate after the randomized administration of theophylline or placebo were included. In total, eight studies involving 498 neonates were eligible. The incidence rate of acute kidney injury was significantly lower in the theophylline group than in the placebo group (risk ratio [RR]: 0.42, 95% confidence interval [CI]: 0.32-0.55, p < 0.001). The changes in serum creatinine level in the theophylline group were significantly higher than those in the placebo group from the first day of life to 3 and 5 days of age (weighted mean difference [WMD]: -0.51, 95% CI: -0.62 to -0.40, p < 0.001, and WMD: -0.26, 95% CI: -0.34 to -0.18, p < 0.001, respectively). The changes in glomerular filtration rate in the theophylline group were significantly higher than those in the placebo group from the first day of life to 3 days of age and the last day of follow-up (WMD: 12.30, 95% CI: 9.39-15.21, p < 0.001, and WMD: 9.35, 95% CI: 6.43-12.27, p < 0.001, respectively). These results suggested that theophylline has a beneficial effect on the prevention of acute kidney injury in neonates with perinatal asphyxia.

• Journal of Korean Academy of Nursing
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• v.50 no.6
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• pp.740-756
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• 2020

Purpose: The purpose of this study was to evaluate the effect on blood pressure (BP) and heart rate (HR) according to aerobic exercise characteristics in adults with hypertension using a systematic review and meta-analysis. Methods: The related researches were selected from PubMed, EMBASE, Cochrane library, CINAHL, PsycINFO, SPORTDiscus and 5 domestic databases up to September 4, 2019. To estimate the effect size, random effect models were used to derive weighted mean differences (WMD) and their 95% confidence intervals (CI) of aerobic exercise on BP and HR. Results: A total of 37 RCTs with 1,813 samples were included. Aerobic exercise was found to significantly reduce systolic BP (WMD, - 8.29 mmHg; 95% CI, - 10.12 to - 6.46), diastolic BP (WMD, - 5.19 mmHg; 95% CI, - 6.24 to - 4.14) and HR (WMD, - 4.22 beats/min; 95% CI, - 5.36 to -3.09). In detail, systolic BP and diastolic BP were significantly decreased in all groups of exercise types, frequency and duration. Systolic BP and diastolic BP were significantly decreased in the moderate and vigorous-intensity group. Exercise characteristics with the most dramatical change in systolic BP were water-based training, moderate-intensity, 3 times a week and 8 to 11 weeks of duration. In diastolic BP, the greatest effect size was over 24 weeks of exercise. Conclusion: Moderate aerobic exercise, especially water-based exercise can be an important part of lifestyle modification for hypertensive patients. Also, it can be recommended in a variety of clinical settings for lowering BP and HR. However, there is insufficient evidence that low-intensity exercise is effective in lowering BP.

• Journal of Periodontal and Implant Science
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• v.52 no.5
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• pp.352-369
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• 2022

The aim of this systematic review was to evaluate clinical and microbiological outcomes with the use of azithromycin as an adjunct to non-surgical subgingival professional mechanical plaque removal (PMPR) in the treatment of grade C periodontitis. Online database searches using high-level MeSH terms in a PICO structure were conducted along with hand-searching of relevant periodontal journals. Titles and abstracts of identified studies were independently reviewed by both authors and the full texts of studies meeting the inclusion criteria were independently reviewed. In total, 122 studies were identified through searches, of which 6 were included in the qualitative analysis and 4 in the meta-analysis. Three studies included in the meta-analysis were deemed at low risk of bias and 1 at serious risk. There were conflicting results on whether azithromycin reduced the number of subgingival pathogens or detectable subgingival Aggregatibacter actinomycetemcomitans between the included studies. The meta-analysis revealed a statistically significant probing depth reduction difference in favour of azithromycin compared to the control at 3 months (weighted mean difference [WMD]=-0.39 mm; 95% confidence interval [CI], -0.66 to -0.13 mm; I²=0%) and 12 months (WMD=-1.32 mm; 95% CI, -1.71 to -0.93 mm; I²=0%). The clinical attachment level change was also statistically significant in favour of azithromycin compared to the control at 3 months (WMD=-0.61 mm; 95% CI, -1.13 to -0.10 mm; I²=71%) and 12 months (WMD=-0.88 mm; 95% CI, -1.32 to -0.44 mm; I²=0%). Based upon these results, azithromycin offers additional improvements in some clinical parameters when used in conjunction with subgingival PMPR in patients with aggressive periodontitis over control groups. These improvements appear to be maintained for up to 12 months after treatment completion. However, due to a lack of well-designed studies, the conclusions that can be drawn from the available evidence are limited.

• Clinical Nutrition Research
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• v.11 no.2
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• pp.120-132
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• 2022

Numerous clinical trials have examined the beneficial effects of Juglans regia leaf extract (JRLE) in patients with type 2 diabetes mellitus (T2DM); however, the results of these studies are inconsistent. Therefore, we conducted the current systematic review and meta-analysis to evaluate the effect of JRLE on glycemic control and lipid profile in T2DM patients. We searched online databases including PubMed, Scopus, EMBASE, and Web of Science for randomized controlled clinical trials that examined the effect of JRLE on glycemic and lipid indices in T2DM patients. Data were pooled using both fixed and random-effect models and weighted mean difference (WMD) was considered as the overall effect size. Of the total records, 4 eligible studies, with a total sample size of 195 subjects, were included. The meta-analysis revealed that JRLE supplementation significantly reduces fasting blood glucose (WMD, -18.04; 95% confidence interval [CI], -32.88 mg/dL, -3.21 mg/dL; p = 0.017) and significantly increases fasting insulin level (WMD, 1.93; 95% CI, 0.40 U/L, 3.45 U/L; p = 0.014). Although the overall effect of JRLE supplementation on hemoglobin A1c was not significant, a significant reduction was seen in studies with an intervention duration of > 8 weeks (WMD, -0.64; 95% CI, -1.16%, -0.11%; p = 0.018). Moreover, we also found no significant change in lipid parameters. Our findings revealed a beneficial effect of JRLE supplementation on glycemic indices in T2DM patients, but no significant improvement was found for lipid profile parameters.

• Clinical Nutrition Research
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• v.13 no.3
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• pp.201-213
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• 2024

This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to test our hypothesis that herbal tea may improve anthropometric parameters, metabolic factors, and hormone levels in women with polycystic ovarian syndrome (PCOS). A literature search was conducted on Information Sciences Institute, Medline (PubMed), Scopus, Embase, and Google Scholar, up to March 2023 without applying language or date restrictions. RCTs that assigned herbal tea vs. placebo on PCOS women and evaluated changes in anthropometric measurements, metabolic indices, or hormonal profiles were included. Six RCTs with 235 PCOS women (119 in the intervention and 116 in the control group) were included. Meta-analysis showed that herbal tea consumption led to significant decreases in weight (weighted mean difference [WMD], -2.02 kg; 95% confidence interval [CI], -3.25, -0.80), body mass index (BMI) (WMD, -0.88 kg/m²; 95% CI, -1.47, -0.28) and fasting blood glucose (FBG) (WMD, -6.47 mg/dL; 95% CI, -8.49, -4.45), compared to the control group. Herbal tea supplementation has also significantly increased follicle-stimulating hormone (FSH) concentration (WMD, 0.56 IU/L; 95% CI, 0.17, 0.95). Meanwhile, the effect of herbal tea on the waist/hip ratio, hip circumference, waist circumference, body fat, fasting insulin, FBG/insulin ratio, luteinizing hormone, total testosterone, and dehydroepiandrosterone sulfate was not significant. Herbal tea might be a potential supplemental therapy to manage weight, BMI, FBG, and FSH in PCOS women. Further large randomized clinical trials are recommended to affirm these findings.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.6
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• pp.116-126
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• 2020

This study analyzed the effects of auricular acupressure on improving sleep disorders of the elderly. The data was collected from domestic and foreign databases. The keywords were 'auricular,' 'sleep,' 'insomnia, and so on. RoB and RoBANS were used to evaluate the risk of bias in the selected literature. Meta-analysis was performed using RevMan 5.3. Seven of 386 studies were selected. Regarding the sleep score, those studies with an intervention period of less than four weeks showed WMD of 25.66 (95% CI; 20.18 to 31.14), which was significantly higher than that of the control group. Similarly, the studies with an intervention period longer than four weeks had significantly higher WMD than that of the control group, and the former exhibited WMD of 8.59 (95% CI: 6.26 to 10.92). In contrast, sleep satisfaction was significantly higher in the studies with a maintenance period of three days or less, which resulted in SMD of 13.37 (95% CI: 5.29 to 21.45). The score in the studies with a maintenance period longer than four days was significantly higher than that of the control group with SMD of 2.27 (95% CI: 1.82 to 2.72). Auricular acupressure was effective in alleviating sleep disorders among the elderly in terms of both sleep quality and sleep satisfaction.

• Strategy21
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• s.41
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• pp.232-260
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• 2017

The purpose of this paper is to open a debate about what kind of deterrent strategy the ROK military should pursue in the era of NK's weapons of mass destruction and missile threats. I argue that the ROK military needs a comprehensive deterrent strategy that reflects the international security situations and trends and that builds on clear understanding of the basic concepts and how deterrence operates. The paper starts with surveying the basic knowledge of deterrence from the perspectives of both theory and practice. Then, it provides explanations on why deterrence against NK can be particularly difficult given the security environment in and around the Korean peninsula. For example, South Korea and North Korea hardly share 'common knowledge' that serves as a basic element for the operation of deterrence. Deterrence against North Korea involves complex situations in that both deterrence and compellence strategies may be relevant particularly to North Korea's WMD and missile threats. It also involves both immediate and general deterrence. Based on the discussion, I suggest several ideas that may serve as guidelines for establishing a deterrent strategy against NK. First, our threats for deterrence should be the ones that can be realized, particularly in terms of the international norms. In other words, they must be considered appropriate among other nations in the international community. Second, there should be separate plans for the different kinds of threats: one is conventional, local provocations and the other is WMD/missile related provocations. Third, we should pursue much closer cooperative relations with the U.S. military to enhance the effectiveness of immediate deterrence in the Korean peninsula. Fourth, the ROK military should aim to accomplish 'smart deterrence' maximizing the benefits of technological superiority. Fifth, the ROK military readiness and structure should be able to deny emerging North Korean military threats such as the submarine-launched ballistic missiles and intercontinental ballistic missiles. Lastly, in executing threats, we should consider that the current action influences credibility and reputation of the ROK, which in turn affect the decisions for future provocations. North Korea's WMD/missile threats may soon become critical strategic-level threats to South Korea. In retrospect, the first debate on building a missile defense system in South Korea dates back to the 1980s. Mostly the debate has centered on whether or not South Korea's system should be integrated into the U.S. missile defense system. In the meantime, North Korea has become a small nuclear power that can threaten the United States with the ballistic missiles capability. If North Korea completes the SLBM program and loads the missiles on a submarine with improved underwater operation capability, then, South Korea may have to face the reality of power politics demonstrated by Thucydides through the Athenians: "The strong do what they have the power to do, the weak accept what they have to accept."

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.33 no.3
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• pp.45-68
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• 2020

Objectives : This study aims to evaluate the effectiveness and safety of manual and electroacupuncture on glaucoma. Method : We searched 11 electronic databases using index words to identify randomized clinical trials. Meta-analysis of weighted mean difference (WMD) or standardized mean difference (SMD) were used to evaluate the outcomes. Cochrane bias risk assessment tool was used to assess the risk of bias in each clinical study. The collected data was analyzed using RevMan software (ver. 5.3). Results : At the initial stage of data retrieval, 549 papers were searched. After reviewing 37 full texts, a total of 10 RCT studies (426patients, 715 eyes) were selected and 8 RCT studies (357 people, 617 eyes) were involved in meta-analysis. Meta-analysis of 8 RCTs showed that acupuncture alone was more effective in reducing intraocular pressure(IOP) than conventional treatment (WMD = -5.73, 95% CI: [-12.30, 0.83], P = 0.09, I² = 97%) The combination of acupuncture or electroacupuncture with conventional treatment was also effective in lowering IOP (WMD = -1.84, 95% CI: [-2.31, -1.37], P <0.00001, I² = 45%). It was estimated that the combination of acupuncture with conventional treatment was also effective for improving visual field (VF) (WMD = -2.17, 95% CI: [-4.32, -0.02], P = 0.05, I² = 89%) but improvement in visual acuity (VA) was not significant (MD = 0.06, 95% CI: [-0.03, 0.15], P = 0.23, I² = 0%). Subgroup analyzes were performed only for the studies that used open glaucoma as the study's disease and combination of acupuncture or electroacupuncture with conventional therapy would have an effect on lowering intraocular pressure (WMD = -1.68)., 95% CI: [-2.46, -0.90], P <0.0001, I² = 29%). Conclusion : This study suggests that acupuncture treatment for glaucoma may be effective in reducing intraocular pressure and helpful in improving visual field defects. However, due to the small sample size, high risk of bias and high heterogeneity in the methodology, it is expected that further studies will be needed to verify the results. Further studies in large-scale samples based on a minimized biased methodology would be necessary.

• 해운
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• no.12 s.34
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• pp.42-43
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• 2006

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.42
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• pp.309-335
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• 2009

Over the last several years, regarding to the strategic items, the international community has seen governments make more formal commitments to adopt and implement effective export controls to counter the proliferation of weapons of mass destruction(WMD). United Nations Security Council Resolution 1540(that is "S/RES/1540") stands as the most important of these commitments. Many UN members already have export control laws and regulations in place to prevent the proliferation of weapons of mass destruction. Many members also participate in a variety of formal and informal international arrangements to coordinate their export control efforts. Nonetheless, each of these countries has its own unique legal framework for export controls. This generates considerable diversity in the construction of the specific national legal authorities. Over the last few years, however, a consensus over what constitutes the key elements of effective legal authorities for export controls has begun to emerge. Evidence for this development comes in the identification of best legal authorities or principles at several multilateral conferences on export controls.