• 대한한방내과학회지
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• 제39권6호
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• pp.1150-1167
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• 2018

Objective: The purpose of this study was to investigate the effect reducing blood pressure (BP) using Xuefuzhuyu Decoction (XFZYD) in adults with essential hypertension (EH). Method: Search engine, such as PubMed, EMBASE, Cochrane library, Web of Science, J-STAGE, CiNii, CNKI, OASIS, NDSL, KISS, RISS, and DBpia, were used. The search period was from the beginning of the search engine to June 30, 2018 and there were no limits regarding languages. The selection and extraction of literatures were performed independently by two authors. Meta-analysis was done on the total effective rate (TER), Systolic BP (SBP) and Diastolic BP (DBP). Cochrane's risk of bias (ROB) was used as the methodological quality assessment scale. Results: Twenty studies were finally selected. We observed that a combination treatment using XFZYD and an antihypertensive drug (AHD) was 5.1 times more effective in lowering BP than using AHD alone on TER. The mean differences in SBP and DBP were -10.65 mmHg (95% Confidential Interval (CI) -13.55 mmHg, -7.74 mmHg, P<0.00001), -5.92 mmHg (95% CI -7.14, -4.38, P<0.00001), respectively. Conclusion: A combination treatment using XFZYD and AHD may be more effective in reducing BP than using AHD alone. Because of the poor methodological quality of the studies conducted thus far, high-quality clinical trials will be required in the future.

• 대한통합의학회지
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• 제7권1호
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• pp.81-88
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• 2019

Purpose : The purpose of this study was to examine if there is any correlation between pelvic tilt angle and trunk motion and trunk extensor during trunk forward flexion and to measure trunk motion, onset time of trunk motion, and onset time of trunk extensor activation. Methods : The subjects of this study were 42 healthy adults. The subjects had no back pain due to neurological disease and no experience of back surgery. After pelvic tilt angle was measured, each trunk forward flexion was performed three times. Trunk motion and onset time of trunk motion were measured using Myomotion. Four sensors were used, with one located at the upper thoracic (below $C_7$), the lower thoracic ($T_{12}-L_1$), the sacrum ($S_1$), and at the center of the anterior femur. Onset time of trunk extensors (spinalis, longissimus, gluteus medius, gluteus maximus, biceps femoris, and gastrocnemius) activation was measured using a wireless surface EMG. The EMG amplitude was normalized by using the reference voluntary contraction (RVC). The statistical significance of the results were evaluated using Pearson's correlation test. Results : The correlation between pelvic tilt angle and lumbar motion, onset time of pelvis motion, and onset time of gluteus medius activation was statistically significant in a positive direction (p<.05). The correlation between pelvic tilt angle with pelvis motion, onset time of lumbar motion, and onset time of longissimus activation showed a statistically significant negative correlation (p<.05). Conclusion : The study results provide a significant contribution to our understanding of the lumbar load at the initial stage of trunk flexion. Therefore, it may be possible to provide basic data for evaluation and treatment, such as orthodontic treatment for alignment of the spine and back pain. In addition, it is necessary to focus on normal exercise pattern reeducation as well as pelvic correction during exercise in daily life or in industrial fields.

• International journal of thyroidology
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• 제11권2호
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• pp.123-129
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• 2018

Background and Objectives: Hypermethylation of the tumor suppressor gene RASSF1A and activating mutation of BRAF gene have been recently reported in thyroid cancers. To investigate the role of these two epigenetic and genetic alterations in thyroid tumor progression, methylation of RASSF1A and BRAF mutation were examined in thyroid tumors. Materials and Methods: During 2007 to 2017, 69 papillary carcinomas, 18 nodular hyperplasia, 3 follicular carcinomas, and 13 follicular adenomas were selected. The methylation-specific polymerase chain reaction (MSP) technique was used in detecting RASSF1A methylation and polymerase chain reaction (PCR)-single-stranded conformation polymorphism and sequencing were used for BRAF gene mutation study. Results: The hypermethylation of the RASSF1A gene was found in 84.6%, 100% and 57.9% of follicular adenomas, follicular carcinomas, and papillary carcinomas, respectively. Nodular hyperplasia showed a hypermethylation in 33.3%. The BRAF mutation at V600E was found in 60.7% of papillary carcinoma and 27.0% of nodular hyperplasia, but none of follicular neoplasms. The BRAF mutation was correlated with the lymph node metastasis and MACIS clinical stage. There is an inverse correlation between RASSF1A methylation and BRAF mutation in thyroid lesions. Conclusion: Epigenetic inactivation of RASSF1A through aberrant methylation is considered to be an early step in thyroid tumorigenesis, and the BRAF mutation plays an important role in the carcinogenesis of papillary carcinoma, providing a genetic marker.

• Clinical and Experimental Pediatrics
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• 제62권5호
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• pp.193-197
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• 2019

Alport syndrome (ATS) is an inherited glomerular disease caused by mutations in one of the type IV collagen novel chains (${\alpha}3$, ${\alpha}4$, and ${\alpha}5$). ATS is characterized by persistent microscopic hematuria that starts during infancy, eventually leading to either progressive nephritis or end-stage renal disease. There are 3 known genetic forms of ATS, namely X-linked ATS, autosomal recessive ATS, and autosomal dominant ATS. About 80% of patients with ATS have X-linked ATS, which is caused by mutations in the type IV collagen ${\alpha}5$ chain gene, COL4A5. Although an 80% mutation detection rate is observed in men with X-linked ATS, some difficulties do exist in the genetic diagnosis of ATS. Most mutations are point mutations without hotspots in the COL4A3, COL4A4, and COL4A5 genes. Further, there are insufficient data on the detection of COL4A3 and COL4A4 mutations for their comparison between patients with autosomal recessive or dominant ATS. Therefore, diagnosis of ATS in female patients with no apparent family history can be challenging. Therefore, in this study, we used whole-exome sequencing (WES) to identify mutations in type IV collagen in 2 girls with glomerular basement membrane structural changes suspected to be associated with ATS; these patients had no relevant family history. Our results revealed de novo c.4688G>A (p.Arg1563Gln) and c.2714G>A (p.Gly905Asp) mutations in COL4A5. Therefore, we suggest that WES is an effective approach to obtain genetic information in ATS, particularly in female patients without a relevant family history, to detect unexpected DNA variations.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권5호
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• pp.260-266
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• 2019

Objectives: Dental implants shorter than 8 mm, called short dental implants (SDIs), have been considered to have a lower success rate than standard length implants. But recent studies have shown that SDIs have a comparable success rate, and implant diameter was more important for implant survival than implant length. Also, SDIs have many advantages, such as no need for sinus lifting or vertical bone grafting, which may limit use in medically compromised patients. Materials and Methods: In this study, 33 patients with 47 implants 7-mm long were examined over the last four years. All patients had special medical history and were categorized into 3 groups: systemic disorders, such as diabetes mellitus (controlled or uncontrolled), mental disability, and uncontrolled hypertension; oral cancer ablation with reconstruction, with or without radiotherapy; diverse osteomyelitis, such as osteoradionecrosis and bisphosphonate-related osteonecrosis of the jaw. Most of these patients have insufficient residual bone quality due to mandible atrophy or sinus pneumatization. Results: The implant diameters were 4.0 (n=38), 4.5 (n=8), and 5.0 mm (n=1). Among the 47 implants placed, 2 implants failed before the last followup. The survival rate of 7-mm SDIs was 95.74% from stage I surgery to the last follow-up. Survival rates did not differ according to implant diameter. The mean marginal bone loss (MBL) at 3 months, 1 and 2 years was significantly higher than at implant installation, and the MBL at 1 year was also significantly higher than at 3 months. MBL at 1 and 2 years did not differ significantly. Conclusion: Within the limitations of the present study, the results indicate that SDIs provide a reliable treatment, especially for medically compromised patients, to avoid sinus lifting or vertical bone grafting. Further, long-term follow-up is needed.

• 대한한방내과학회지
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• 제40권4호
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• pp.663-674
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• 2019

Objective: The purpose of this study was to investigate (using a systematic review) the effect of Banhasasim-tang in the treatment of chemotherapy-induced symptoms. Method: A systematic review was conducted to identify the effect of Banhasasim-tang for chemotherapy-induced symptoms. Electronic databases were used, including such as PubMed, Cochrane, CNKI, Wanfang, CiNii, J-STAGE, NDSL, and OASIS. Among others, the main search terms included "cancer", "Banhasasim-tang", "Banxia Xiexin Tang", and "Hangeshashin-to". This study only included randomized controlled trials (RCTs). Results: A total of 14 RCTs were selected. They all identified the effect of Banhasasim-tang in the treatment of chemotherapy-induced symptoms such as nausea, vomiting, and diarrhea. In addition, five of the studies evaluated the preventive effect of Banhasasim-tang on the symptoms. Conclusion: An analysis of 14 RCTs showed that Banhasasim-tang for chemotherapy-induced symptoms might be effective not only for treatment but also for prevention. However, due to the low quality and number of the selected original articles, the significance of this conclusion is somewhat limited. It is hoped that more systematic and rigorous clinical trials will be conducted.

• Journal of Gastric Cancer
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• 제19권2호
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• pp.157-164
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• 2019

Purpose: Although standard radical gastrectomy is recommended after noncurative resection of endoscopic submucosal dissection (ESD) for early gastric cancer in most cases, residual tumor and lymph node metastasis have not been identified after surgery. The aim of this study is to evaluate the feasibility of sentinel node navigation surgery after noncurative ESD. Materials and Methods: This trial is an investigator-initiated, multicenter prospective phase II trial. Patients who underwent ESD for clinical stage T1N0M0 gastric cancer with noncurative resections were eligible. Qualified investigators who completed the prior phase III trial (SENORITA 1) are exclusively allowed to participate. In this study, 2 detection methods will be used: 1) intraoperative endoscopic submucosal injection of dual tracer, including radioisotope and indocyanine green (ICG) with sentinel basins detected using gamma-probe; 2) endoscopic injection of ICG, with sentinel basins detected using a fluorescence imaging system. Standard laparoscopic gastrectomy with lymphadenectomy will be performed. Sample size is calculated based on the inferior confidence interval of the detection rate of 95%, and the calculated accrual is 237 patients. The primary endpoint is detection rate, and the secondary endpoints are sensitivity and postoperative complications. Conclusions: This study is expected to clarify the feasibility of laparoscopic sentinel basin dissection after noncurative ESD. If the feasibility is demonstrated, a multicenter phase III trial will be initiated to compare laparoscopic sentinel node navigation surgery versus laparoscopic standard gastrectomy in early gastric cancer after endoscopic resection.

• The Journal of Korean Physical Therapy
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• 제30권6호
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• pp.234-238
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• 2018

Purpose: Aim of this study was to investigate whether there are ipsilateral motor deficits for visuospatial accuracy and fine movements by making a comparison between stroke patients and healthy subjects. We examined whether ipsilateral motor deficits are influenced by the level of functional movements and muscle strength of the upper and lower extremities of the affected side. Methods: Thirty post-stroke subjects and 20 normal aged matched subjects were recruited. Outcome measures for less-affected side were the tracking task and nine-hole pegboard test. Fugl-Meyer test and motricity index were applied for the measurement of functional movements and muscle strength of affected side. Results: Tracking task and nine-hole pegboard test was significantly different between control and experimental group. In terms of accuracy index according to tracking, the experimental group showed a lower accuracy index in the MCP joint than the control group. However, there were no significant difference relation between the level of motor function of the affected side and the motor deficit level of ipsilateral side. Conclusion: Ipsilateral motor deficits may have significant clinical implications. It needs to be noted that although many patients, families, and medical staff are focused only on motor deficits of the affected side, motor deficits of the sound side can cause difficulties in daily living movements requiring delicate movements. In addition, there was no significant correlation between the level of motor function of the affected side and motor deficits of the sound side.

• Journal of Korean Biological Nursing Science
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• 제21권1호
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• pp.22-36
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• 2019

Purpose: Even though advanced heart failure (HF) severely affects the patient's health-related quality of life (HRQoL), there is little information regarding this issue. This review is aimed to describe the relevant clinical characteristics of patient with advanced HF and identify factors influencing HRQoL in these patients. Methods: Empirical articles were searched from electronic databases issued from January 2000 to June 2018 with using the key terms 'heart failure' and 'quality of life'. There were a total of 22 articles that met the inclusion criteria and were analyzed for this study. Results: First, nine studies among 22 studies clearly stated that their participants were samples of patients with advanced HF. Most reviewed studies showed the New York Heart Association (NYHA) class as the criteria for identifying advanced HF. Second, the level of HRQoL varied depending on the measurement tools utilized by the researchers. Third, the NYHA class, gender, and symptoms were mainly associated with HRQoL in patients with advanced HF. Also, nurse- or physician-led intervention, exercise, spiritual-focused intervention, and palliative care improved the HRQoL of the patients with advanced HF. Conclusion: This study found that the clear application of criteria for advanced HF and the development of advanced HF-specific HRQoL measurement was needed. Prospective studies should be considered for identifying differences in the levels and factors influencing HRQoL in patients with early stage or advanced HF to design patient-centered care.

• 대한임상독성학회지
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• 제16권2호
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• pp.157-160
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• 2018

Chronic silica nephropathy has been associated with tubulointerstitial disease, immune-mediated multisystem disease, chronic kidney disease, and end-stage renal disease. On the other hand, acute intentional exposure is extremely rare. The authors' experienced a 44-year-old man who took rapid cement hardener (sodium silicate) in a suicide attempt whilst in a drunken state. He visited the emergency department approximately 1 hour after ingestion. Information on the material was obtained after 3 L gastric lavage. The patient complained of a sore throat, epigastric pain, and swollen to blood tinged vomitus. Proton pump inhibitors, hemostats, steroid, and fluids were administered. Nine hours after ingestion, he was administered 200 mL hematochezia. Immediately after, a gas-troenterologist performed an endoscopic procedure that revealed diffuse hyperemic mucosa with a color change and variable sized ulceration in the esophagus, whole stomach, and duodenal $2^{nd}$ portion. Approximately 35 hours later, persistent oligouria and progressive worsening of the renal function parameters (BUN/Cr from 12.2/1.2 to 67.5/6.6 mg/dL) occurred requiring hemodialysis. The patient underwent 8 sessions of hemodialysis for 1 month and the BUN/Cr level increased to 143.2/11.2 mg/dL and decreased to 7.6/1.5 mg/dL. He was discharged safely from the hospital. Follow up endoscopy revealed a severe esophageal stricture and he underwent endoscopic bougie dilatation. Acute cement hardener (sodium silicate) intoxication can cause renal failure and strong caustic mucosal injury. Therefore, it is important to consider early hemodialysis and treatment to prevent gastrointestinal injury and remote esophageal stricture.