• 대한통합의학회지
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• 제11권3호
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• pp.185-194
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• 2023

Purpose : This study aimed to investigate the relationship between the characteristics of hemodialysis patients and the occurrence of sarcopenia through a comprehensive literature review. Methods : A systematic literature search was conducted to identify eligible studies in the Cochrane library, PubMed and Embase. In this review, we included all papers published since the initiative's inception and summarized results as of december 2022. Studies that investigated association between sarcopenia diagnosis and hemodialysis patients (aged≥18 years) were included. Ultimately, 16 studies met our selection criteria. The risk of bias was assessed using the Newcastle-Ottawa scale. Results : Fourteen of the sixteen studies (88 %) reported that significant association between sarcopenia diagnosis and hemodialysis patients. However, two studies reported no association between sarcopenia diagnosis and hemodialysis patients. As a factor statistically related to sarcopenia in hemodialysis patients, Mortality (6 studies, 38 %), age (5 studies, 31 %), body composition (4 studies, 25 %), physical activity (2 studies, 13 %), diabetes (2 studies, 13 %), cardiovascular abnormalities (1 studies, 6 %), nutritional status (3 studies, 19 %), and gender (3 studies, 19 %). Conclusion : Our findings highlight the necessity of developing a physical therapy program that accurately reflects the health status of hemodialysis patients. To further investigate the association between the diagnosis of sarcopenia and hemodialysis patients, it is recommended to conduct large-scale longitudinal studies using standardized diagnostic criteria and evaluation methods, as well as analyze potential risk factors. Consequently, this study emphasizes the importance and potential of developing physical therapy programs that effectively address the health consequences associated with hemodialysis. The significance of this research lies in its ability to provide valuable insights and lay the foundation for future studies focused on developing preventive and therapeutic interventions targeting muscle wasting syndrome resulting from hemodialysis.

• 대한통합의학회지
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• 제11권4호
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• pp.1-15
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• 2023

Purpose : This study investigates the effectiveness of digital therapy for stroke patients in Korea. Methods : A comprehensive database search was performed using KCI, Science on, e-article, RISS, KISS and Korea OpenMed databases for randomized controlled trials (RCTs) that studied the effects of digital therapy on patients who had a stroke. This study includes RCTs published from January 2000 to July 15, 2022, which fulfilled the inclusion and exclusion criteria. A total 697 studies were screened and 30 studies were included in the final analysis. Methodological quality was assessed with the Cochrane's RoB (risk of bias) tool. Meta-analysis was performed using CMA 4.0 software. Results : A total of 56 effect sizes were calculated from the 30 selected studies. As a result of the analysis, the overall effect size of digital therapy was .59 (95 % CI=.43-.74). When classified according to type of intervention, VR (virtual reality) (g=.58, 95 % CI=.40-.75), and CACR (computer assisted cognitive rehabilitation) (g=.62, 95 % CI=.30-.95) were statistically significant. VR showed medium to large effect sizes in cognitive function (g=.78, 95 % CI=.20-1.37), psychosocial function (g=.63, 95 % CI=.20-1.07), and physical function (g=.61, 95 % CI=.38-.83). In the CACR, there was a large effect size in cognitive function (g=.84, 95 % CI=.52-1.15), but there was no significant difference in psychosocial function. Also, there was no significant difference between the two interventions in activities of daily living and no significant difference in the effect size of both interventions according to the intervention session. Furthermore, medium to large effect sizes were found for subacute and chronic stroke patients according to the duration of disease. Conclusion : This study presents evidence that digital therapy has a positive effect on various functions of stroke patients in Korea. The researchers expect to actively accept the new paradigm of digital therapy and continue to apply digital therapy in clinical practice.

• 대한통합의학회지
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• 제11권4호
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• pp.177-188
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• 2023

Purpose : To identify trends in studies on the intersection of neurofeedback (NF) training and rehabilitation interventions for patients with stroke, as conducted over the past decade. Methods : This review included studies published from 2012 to 2022. A comprehensive database search was conducted using keywords such as "stroke", "electroencephalogram (EEG)", "brain wave", "nerve feedback", and "upper extremity function". Results : A total of 703 studies were initially retrieved. Of these, literature predating 2012, duplicate literature, non-experimental studies, and studies that did not target patients with stroke were excluded. After this screening, we retrieved the full texts of 15 articles and re-checked whether each study met the inclusion criteria of this study. The advisory members who participated in this study consisted of people with doctoral degrees and more than 5 years of clinical experience related to the rehabilitation of patients with stroke. Disagreements were resolved through discussions. Ultimately, 8 papers met the inclusion criteria and were included in the final analysis. Despite differences in the type and duration of NF training, the combination of NF training and rehabilitation intervention was found to be effective in promoting the functional recovery of the upper extremities, eliciting positive EEG changes, and inducing neurological changes in the brain. Conclusion : A meta-analysis involving a wider search range is needed in future studies. In addition, efforts are required to generalize the clinical application of these interventions. This can be achieved by supplementing the research methodologies through extensive review studies that encompass a diverse array of study designs.

• 대한통합의학회지
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• 제12권1호
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• pp.183-190
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• 2024

Purpose : This study aims to conduct a comprehensive comparison and analysis of intervention strategies utilized for school-aged children facing difficulties in writing, focusing on evaluating the effectiveness of various intervention approaches both domestically and internationally. The primary focus is on assessing the efficacy of each intervention approach and identifying gaps in the existing literature. Methods : Data for this study were gathered from the domestic database RISS from January 2013 to March 2020, and international databases Pubmed and Google Scholar were utilized. The keywords for domestic literature search included 'occupational therapy', 'handwriting', and 'school-aged', while for international literature search, the keywords were 'occupational therapy', 'handwriting', and 'children'. A total of 4 international and 2 domestic articles were selected for review based on predetermined inclusion and exclusion criteria. Results : The study findings present a thorough comparative analysis of intervention strategies, categorizing them into task-oriented intervention, sensory-motor intervention, and integrated intervention. All intervention methods demonstrated notable improvements in the legibility of handwriting. Comparison between domestic and international literature revealed a predominant use of task-oriented intervention in domestic studies, while international studies showcased a diverse range of intervention methods. Conclusion : Interventions were categorized into computer-based, task-oriented, sensory-motor, and integrated interventions. Task-oriented interventions were the most common in both domestic and international studies, while integrated interventions were the most effective. Based on these findings, it is necessary to increase awareness of the need for handwriting intervention research among occupational therapists in Korea. Additionally, there is a need for well-supported handwriting intervention research with larger sample sizes in both domestic and international occupational therapy. Finally, future research should actively investigate the application of tailored integrated interventions for school-aged children with handwriting difficulties.

• 대한통합의학회지
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• 제12권1호
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• pp.41-48
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• 2024

Purpose : This study aims to understand the effects of job-seeking stress on depression and self-esteem in college students majoring in health science. Methods : In this study, in order to measure college students' employment stress, depression, self-esteem, and social support, a measurement tool was used by modifying and supplementing the questionnaire to suit the purpose and method of this study. The subjects, 210 students (46 men and 164 women) enrolled in colleges located in Busan, had their scores on the Beck depression inventory (BDI), job-seeking stress scale, and self-esteem scale measured. Results : There was a positive correlation between all sub-variables of employment stress, and a negative correlation between employment stress and self-esteem. Additionally, a positive correlation was found between employment stress and depression, and a negative correlation was found between self-esteem and depression. The result taken from the job-stress scale showed that women experienced an overall higher level of stress than men while seeking jobs. Furthermore, in terms of the BDI, men exhibited a higher level of depression than women when subjected to job-seeking stress. Finally, the results from the self-esteem scale reveal that men exhibited less self-esteem than women. Conclusion : A comprehensive review of the study's findings suggested that women had greater job-seeking stress than men. Additionally, it found that, for men, job-seeking stress had a greater impact on depression levels and self-esteem. These results suggest that a higher level of job-seeking stress may lead to higher levels of depression and lower levels of self-esteem. It will be useful to conduct follow-up research by operating self-esteem and depression programs.

• 대한통합의학회지
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• 제10권4호
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• pp.229-240
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• 2022

Purpose : In this study, using Oyster Shell Thermal Therapy for metabolic diseases, we analyzed the effect of immune and inflammation-related variables and respiratory health-related variables of test subjects to verify the effect of improving respiratory health. Methods : In this study, 26 patients with metabolic diseases were divided into an experimental group (N=13) and a control group (N=13). After Oyster Shell Thermal Therapy (four weeks/three times a week/1 hour per time), metabolic disease-related variables and immune and respiratory health-related variables were measured and compared between the two groups. The conclusion of this study is as follows: Results : After the four-week Oyster Shell Thermal Therapy, in terms of changes in the metabolic disease-related variables, the control group exhibited a higher increase in TC and LDL-C levels than the experimental group. In the case of glucose, the experimental group showed a decrease after the experiment (p<.05). After the four-week thermotherapy, a statistically significant interactive effect occurred in natural killer (NK) cells among the immune-related variables. According to the results of a post-experimental analysis, the control group showed a higher decrease in NK cells than the experimental group (p<.05). After the 4-weeks thermotherapy, the experimental group showed a greater increase in maximum oxygen intake of the respiratory health-related variables than the control group. Conclusion : Based on a comprehensive review of the study results, the subjects who underwent the four-week Oyster Shell Thermal Therapy exhibited positive physical changes in metabolic disease-related variables as well as immune and respiratory health-related variables, which demonstrates the effectiveness of Oyster Shell Thermal Therapy on immune and respiratory health. Accordingly, it is recommended to conduct long-term Oyster Shell Thermal Therapy with various models in terms of the size and shape.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2793-2800
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• 2015

In molecular-targeted cancer therapy, acquired resistance to gemcitabine is a major clinical problem that reduces its effectiveness, resulting in recurrence and metastasis of cancers. In spite of great efforts to reveal the overall mechanism of acquired gemcitabine resistance, no definitive genetic factors have been identified that are absolutely responsible for the resistance process. Therefore, we performed a cross-platform meta-analysis of three publically available microarray datasets for cancer cell lines with acquired gemcitabine resistance, using the R-based RankProd algorithm, and were able to identify a total of 158 differentially expressed genes (DEGs; 76 up- and 82 down-regulated) that are potentially involved in acquired resistance to gemcitabine. Indeed, the top 20 up- and down-regulated DEGs are largely associated with a common process of carcinogenesis in many cells. For the top 50 up- and down-regulated DEGs, we conducted integrated analyses of a gene regulatory network, a gene co-expression network, and a protein-protein interaction network. The identified DEGs were functionally enriched via Gene Ontology hierarchy and Kyoto Encyclopedia of Genes and Genomes pathway analyses. By systemic combinational analysis of the three molecular networks, we could condense the total number of DEGs to final seven genes. Notably, GJA1, LEF1, and CCND2 were contained within the lists of the top 20 up- or down-regulated DEGs. Our study represents a comprehensive overview of the gene expression patterns associated with acquired gemcitabine resistance and theoretical support for further clinical therapeutic studies.

• 한국환경보건학회지
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• 제47권3호
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• pp.227-244
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• 2021

Objectives: The Korean National Environmental Health Survey provides representative biomonitoring data for environmental pollutants in South Korea. Over the last decade, there have been various studies published using this data. In this study, we aimed to provide information and implications by reviewing each study. Methods: We searched comprehensive electronic databases from PubMed, Google Scholar, and Naver Academic database using the key words 'Korean National Environmental Health Survey' and 'KoNEHS' through March 2021. A total of 57 studies were selected after reviewing the relevance of the data. Results: The most frequently studied pollutants were heavy metals (10), Cotinine (8), Bisphenol A (7), and Phthalates (6), in that order. In particular, Phthalates, Bisphenol A, and Parabens were often studied together (6). A decline in urinary cotinine and heavy metals in the body was shown over time among studies on exposure association. It was demonstrated that Phthalates and Bisphenol A were significantly related to obesity and diabetes from the studies of health impacts. Cross-section study design, spot urine, and insufficient health status information were mostly reported as limitations of the data. Conclusion: Since research has been focused on adults, further investigations of children and adolescents are required. In this regard, it is necessary to maintain the consistency of the data structure and provide integrated weights for all ages. In addition, it would allow the measurement of several environmental pollutants by considering subsample design. Lastly, integrated studies with multi-cycles and the health effects from co-exposure to multiple chemicals would be expected to provide important knowledge.

• Journal of Ginseng Research
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• 제46권2호
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• pp.235-247
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• 2022

Background: Ginsenoside Rg3 is one of the main active ingredients in ginseng. Here, we aimed to confirm its protective effect on the heart function in transverse aortic coarctation (TAC)-induced heart failure mice and explore the potential molecular mechanisms involved. Methods: The effects of ginsenoside Rg3 on heart and mitochondrial function were investigated by treating TAC-induced heart failure in mice. The mechanism of ginsenoside Rg3 for improving heart and mitochondrial function in mice with heart failure was predicted through integrative analysis of the proteome and plasma metabolome. Glucose uptake and myocardial insulin sensitivity were evaluated using micro-positron emission tomography. The effect of ginsenoside Rg3 on myocardial insulin sensitivity was clarified by combining in vivo animal experiments and in vitro cell experiments. Results: Treatment of TAC-induced mouse models with ginsenoside Rg3 significantly improved heart function and protected mitochondrial structure and function. Fusion of metabolomics, proteomics, and targeted metabolomics data showed that Rg3 regulated the glycolysis process, and Rg3 not only regulated glucose uptake but also improve myocardial insulin resistance. The molecular mechanism of ginsenoside Rg3 regulation of glucose metabolism was determined by exploring the interaction pathways of AMPK, insulin resistance, and glucose metabolism. The effect of ginsenoside Rg3 on the promotion of glucose uptake in IR-H9c2 cells by AMPK activation was dependent on the insulin signaling pathway. Conclusions: Ginsenoside Rg3 modulates glucose metabolism and significantly ameliorates insulin resistance through activation of the AMPK pathway.

• 대한한의학회지
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• 제38권2호
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• pp.61-72
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• 2017

Objectives: The effects of Gamiondam-tang (GMODT) co-administration within 5min on the pharmacokinetics (PK) of tamoxifen were observed as a process of the comprehensive and integrative medicine, combination therapy of tamoxifen with GMODT to achieve synergic pharmacodynamics and reduce toxicity on the breast cancer. Methods: After 50mg/kg of tamoxifen treatment, GMODT 100mg/kg was administered within 5min. The plasma were collected at 30 min before administration, 30 min, 1, 2, 3, 4, 6, 8 and 24 hrs after end of GMODT treatment, and plasma concentrations of tamoxifen were analyzed using LC-MS/MS methods. PK parameters of tamoxifen (Tmax, Cmax, AUC, $t_{1/2}$ and $MRT_{inf}$) were analysis as compared with tamoxifen single administered rats using noncompartmental pharmacokinetics data analyzer programs. Results: Co-administration with GMODT induced increased trends of plasma tamoxifen concentrations to 1hr after end of administration, and then showed decreased trends of plasma tamoxifen concentrations, and especially significant (p<0.05) increases of plasma tamoxifen concentrations were demonstrated at 0.5hr after end of co-administration with GMODT and also related significant (p<0.05) decreases of $AUC_{0-inf}$ and $MRT_{inf}$ as compared with tamoxifen single formula treated rats, at dosage levels of tamoxifen 10 mg/kg and GMODT 100 mg/kg within 5 min, in this experiment. Conclusion: Based on the results of the present study, it is considered that single co-administration GMODT within 5min significantly inhibited the oral bioavailability of tamoxifen through variable influences on the absorption and excretion of tamoxifen, can be influenced on the toxicity or pharmacodynamic of tamoxifen.