• Journal of Dental Anesthesia and Pain Medicine
• /
• 제21권6호
• /
• pp.527-545
• /
• 2021

The aim of this systematic review was to determine the success rate of nitrous oxide-oxygen procedural sedation (NOIS) in dentistry. A systematic digital search was conducted for publications or reports of randomized controlled trials evaluating the clinical performance of NOIS. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who met the inclusion and exclusion criteria accordingly. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool (RoB 2). A total of 19 articles (eight randomized clinical trials with parallel intervention groups and 11 crossover trials), published between May 1988 and August 2019, were finally selected for this review. The studies followed 1293 patients reporting NOIS success rates, with a cumulative mean value of 94.9% (95% CI: 88.8-98.9%). Thirteen trials were conducted on pediatric populations (1098 patients), and the remaining six were conducted on adults (195 patients), with cumulative efficacy rates of 91.9% (95% CI: 82.5-98.1%) and 99.9% (95% CI: 97.7-100.0%), respectively. The difference was statistically significant (P = 0.002). Completion of treatment and Section IV of the Houpt scale were the most used efficacy criteria. Within the limitations of this systematic review, the present study provides important information on the efficacy rate of NOIS. However, further well-designed and well-documented clinical trials are required and there is a need to develop guidelines for standardization of criteria and definition of success in procedural sedation. Currently, completion of treatment is the most used parameter in clinical practice, though many others also do exist at the same time. To maximize NOIS efficacy, clinicians should strictly consider appropriate indications for the procedure.

• 대한한방소아과학회지
• /
• 제36권3호
• /
• pp.1-18
• /
• 2022

Objectives The purpose of this study was to investigate the current status of interventional clinical trial registration for children with precocious puberty and to secure basic data for the design of clinical trials for traditional Korean medicine treatment of precocious puberty. Methods The following resources were used to search for data: Clinicaltrial.gov, World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), and Clinical Research Information Service (CRIS), using the search terms, 'Precocious puberty', 'child'. All clinical trials which were registered as of June 2022 were used. Results For the intervention and clinical trial design, gonadotropin releasing hormone (GnRH) analog was reported in 41.7% of trials, and single group assignment was performed in 66.7% of the studies. Prior consent had not been reported in 50% of the studies. Tanner stage and GnRH stimulation tests were reported by multiple trials as inclusion criteria, and prior treatment experiences for trial drugs were reported as exclusion criteria. The peak serum concentration of luteinizing hormone following GnRH stimulation test was used as a primary outcome in 45.8% of clinical trials, and other growth-related indicators such as growth rate, height, and predicted adult height were also reported. Conclusions In consideration of the design, eligibility criteria, and outcome measurement of the existing clinical trials identified in this study, it should be referred to in the design of clinical trials for traditional Korean medicine treatment of precocious puberty.

• 보건행정학회지
• /
• 제20권4호
• /
• pp.45-57
• /
• 2010

Background : If different cost efficiency indexes were informed to the same clinic depending on the inclusion or exclusion of pharmacy cost, it may impair the reliability of provider-profiling system. This study aimed to investigate whether the omission of pharmacy cost affects cost-efficiency rankings in medical clinics. Methods : Data for ambulatory care cost at 23,112 medical clinics were collected from the claims database, which was constructed after review by the Health Insurance Review and Assessment Service (HIRA) of Korea in April 2007. We calculated two types of cost efficiency indexes by inclusion or exclusion of pharmacy cost for a medical clinic. The agreement between the decile rankings of the two indexes was also assessed using the weighted kappa statistic of Landis and Koch. Results : When the cost efficiency index for total cost including pharmacy cost was compared with the index for total cost excluding it, the agreement between the two indexes was only 55%. The agreements between the two indexes were relatively low within specialties which have larger pharmacy volume of total cost and lower correlation between total cost with or without pharmacy cost included than the average level of all the specialties. Conclusion : These results suggest that the omission of pharmacy cost may result in contradictory outcomes that may be confusing to a medical institution and may impair the reliability of provider-profiling systems. It is very important to standardize profiling criteria for the reliability of provider profiling system.

• 토지주택연구
• /
• 제7권1호
• /
• pp.43-51
• /
• 2016

장기수선계획은 공동주택 수선공사의 시행 기준으로서 장기수선충당금의 적립과 예방보전을 통한 효과적인 시설물관리의 기반을 제공하는 것이며 정부에서는 장기수선계획의 중요성을 감안하여 공동주택의 장기수선공사를 위한 대상항목과 수선주기, 수선율을 법으로 정하고 있다. 그러나 수립기준에 포함된 수선공사의 항목이 최근의 공법 등을 반영하여 적기에 개정되지 못함에 따라 실제 아파트 단지에서 장기수선계획의 빈번한 변경, 수선공사를 둘러싼 논란, 충당금 사용 상의 어려움을 가져오고 있다. 이러한 문제를 해결하기 위해서는 실태분석을 통해 계획수선 항목의 적정성을 평가하여 수립기준을 조정하는 것이 요구된다. 본 연구에서는 장기수선계획과 수선공사 데이터를 통해 파악할 수 있는 현황을 바탕으로 주요 수선항목을 도출하고 수립기준을 조정하는 방안을 제안함으로써 장기수선계획의 운영을 담당하는 관리주체의 부담을 저감함과 동시에 적정수준의 수선충당금 적립을 유도하여 건물 내구연한의 연장과 수선공사 실질화를 위한 방안을 제안하고자 하였다. 이를 위해 광범위하게 장기수선계획 사례를 수집하여 계획에의 항목 채택률을 검토하고, 장기수선충당금 사용내역과 관리비 상의 수선유지비 내역을 분석하였다. 주요 항목을 도출함에 있어서는 보수적인 방식으로서 불필요한 항목만을 최소한으로 삭제하는 배제방식과 각 항목의 계획 반영률이 일정 수준 이상이면서 공사내역이 있는 항목만을 가려내는 선택방식 등 두 가지 방식으로 접근하였다. 그 결과 현재의 147개 항목 중 118개와 73개 항목이 배제방식과 선택방식을 통해 각각 주요 항목으로 정리되었다. 장기수선계획 수립을 위한 법적기준은 실제 적용되는 공법과 재료의 현황을 주기적으로 반영하는 것이 필요하다는 점에서 본 연구의 결과는 기준의 실용성 제고에 기여할 것으로 기대된다.

• 한방안이비인후피부과학회지
• /
• 제26권3호
• /
• pp.1-19
• /
• 2013

Objective : The primary purpose of present study is to evaluate the effect of herbal cosmetics containing Cortex Betulae Platyphyllae extract complex on acne. The second is to comparatively evaluate safety of this cosmetics. Methods : We opened collecting of applicant that men and women(the 18~35-year-old) with acne on face. We selected subjects who came up to entire inclusion criteria and were not included in the exclusion criteria. We checked changes of Acne Global score, skin sebum, moisture, pores counts, Skindex-29 for 8 weeks. Results : 1. Comparison of changes in Global score, it declined in both experimental group and control group. But Experimental group showed a statistically significant decline than control group. 2. Comparison of changes in sebum and moisture, it declined in both experimental group and control group. But there was no statistically significant difference between those two groups. 3. Comparison of changes in erythema normal area, it declined in both experimental group and control group. But there was no statistically significant difference between those two groups. 4. Comparison of changes in pore counts, it increased statistically significantly in both experimental group and control group. 5. Comparison of changes in Skindex-29, it declined in both experimental group and control group. But there was no statistically significant difference between those two groups. Conclusion : Considering the above experiments, it is suggested that herbal cosmetics containing Cortex Betulae Platyphyllae extract complex have a positive effect on acne.

• 한방재활의학과학회지
• /
• 제28권3호
• /
• pp.39-53
• /
• 2018

Objectives The aim of this study was to analyze the herbal prescription and composition of the leading experimental studies of herbal medicine extract in arthritis model and to analyze the way of setting model and the way of validating effect of the leading experimental studies of herbal medicine extract in arthritis model. Methods The Subjects were selected by select criteria and exclusion criteria from January 1, 2000 to September 30, 2017. The herbal prescription and composition of the selected subjects were analyzed. The effects and statistical significance of selected studies were verified by comparing the control and treatment groups of frequently used cytokines (tumor necrosis factor $[TNF]-{\alpha}$, interleukin $[IL]-1{\beta}$, IL-6). Results 52 kinds of herbal prescriptions and 118 kinds of individual herbs were used in 64 studies. Among the 52 kinds of herbal prescriptions, Daeganghwal-tang (4 times) was used most frequently. Among the 118 kinds of individual herbs, Glycyrrhizae Radix (49 times), Angelicae Giantis Radix (34 times), Osterici Radix (24 times) were used most frequently in order. The prescription that has the highest $TNF-{\alpha}$ decline is Changchooldoin-tang. The prescription that has the highest $IL-1{\beta}$ decline is Banggibokryeong-tang. The prescription that has the highest IL-6 decline is Gwanjeol8ho-bang. Conclusions Daeganghwal-tang (herbal prescription) and Glycyrrhizae Radix, Angelicae Giantis Radix, Osterici Radix (individual herbs) were used most frequently. The prescriptions that have the highest cytokines decline were Changchooldoin-tang, Banggibokryeong-tang and Gwanjeol8ho-bang.

• 대한예방한의학회지
• /
• 제22권1호
• /
• pp.15-28
• /
• 2018

Objectives : The purpose of this study was to analyze the trend of clinical research on quantitative indicators of Mibyeong in traditional chinese medicine(TCM). Method : The journal search was performed using china national knowledge infrastructure(CNKI) database. Our inclusion criteria were as following: TCM clinical researches for quantitative indicators of Mibyeong. Exclusion criteria were as following: non-TCM clinical researches, used intervention methods. Results : Eleven clinical researches were analyzed in this study. Four of these researches classify the Mibyeong as a type of pattern identification(PI) and studied the characteristics of the PI quantitative indicators. Mibyeong diagnosis was done through guidelines and questionnaires, each was used at a similar rate. Quantitative indicators mentioned in the selected researches were blood indices, nailfold capillary, complexion, color of tongue substance and coating, pulse wave diagrams and heart rate variability. Among them, seven researches related to blood indices were the most. Blood indicators include whole-blood viscosity, plasma viscosity, fibrinogen, packed cell volume(Hct), triglycerides, total cholesterol, HDL-C, LDL-C, glucose, BUN/CREA, luteinzing hormone, estradiol, follicle stimulating hormone, IgA, IgG, etc. Conclusions : Based on this results, in combination with western medicine, it seems necessary to try to interpret the Mibyeong in more various ways. Even if the same Mibyeong, it is necessary to identify the index which changes according to the PI or chief complaint, and to set the Mibyeong standard corresponding thereto.

• Journal of Trauma and Injury
• /
• 제33권1호
• /
• pp.38-42
• /
• 2020

Purpose: Immediate post-laparotomy hypotension (PLH) is a precipitous drop in blood pressure caused by a sudden release of abdominal tamponade after laparotomy in cases of severe hemoperitoneum. The effect of laparotomy on blood pressure in patients with significant hemoperitoneum is unknown. Methods: In total, 163 patients underwent laparotomy for trauma from January 1, 2013 to December 31, 2015. Exclusion criteria included the following: negative laparotomy, only a hollow viscous injury, and hemoperitoneum <1,000 mL. After applying those criteria, 62 patients were enrolled in this retrospective review. PLH was defined as a decrease in the mean arterial pressure (MAP) ≥10 mmHg within 10 minutes after laparotomy. Results: The mean estimated hemoperitoneum was 3,516 mL. The incidence of PLH was 23% (14 of 62 patients). The MAP did not show significant differences before and after laparotomy (5 minutes post-laparotomy, 67.5±16.5 vs. 68.3±18.8 mmHg; p=0.7; 10 minutes post-laparotomy, 67.5±16.5 vs. 70.4±18.8 mmHg; p=0.193). The overall in-hospital mortality was 24% (15 of 62 patients). Mortality was not significantly higher in the PLH group (two of 14 [14.3%] vs. 13 of 48 [27.1%]; p=0.33). No statistically significant between-group differences were observed in the intensive care unit and hospital stay. Conclusions: PLH may be less frequent and less devastating than it is often considered. Surgical hemostasis during laparotomy is important. Laparotomy with adequate resuscitation may explain the equivalent outcomes in the two groups.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권6호
• /
• pp.2541-2546
• /
• 2014

Background: Primary hepatic neuroendocrine carcinoma (PHNEC) is rarer than extrahepatic gastrointestinal neuroendocrine carcinoma (NEC). It is difficult to make a correct diagnosis and poses a challenge for management. Materials and Methods: Ten PHNEC patients were admitted to our hospital from June 2006 to June 2011. Laboratory tests and imaging scans were performed for diagnosis and exclusion of extrahepatic NEC. All patients were AFP - and CA199-. Seven patients had solid tumors with cystic changes on ultrasonography, CT and/or MRI. For the initial treatment, four patients received combined-therapy and six monotherapy. Considering overall treatment, six patients received combined-therapy and four patients monotherapy. Staging criteria of primary hepatocellular carcinoma (PHC, AJCC 7th edition) were used to differentiate the stage of all patients: 3 patients were stage I, 2 stageII, 4 patients stageIII and 1 stageIV. All patients were followed up and clinical data were gathered. Results: The median follow-up duration was 38.5 months. The 1-year, 2-year, 3-year and 6-year disease-free survival was 80.0%, 46.2% and 46.2% and 0% respectively. The overall survival rates were 100%, 67.1%, 67.1% and 33.6% respectively. Patients in early-stages (I/II) had similar disease-free and overall survival as those in advanced-stages (III/IV). Patients with monotherapy had significant shorter disease-free and overall survival than the patients with combination-therapy. Conclusions: PHNEC has a unique specificity during its occurrence and development. The staging criteria of PHC might not be suitable for the PHENT. More convenient and effective features need to be found in imaging and laboratory detection. Surgical resection, TACE, chemotherapy and radiofrequency ablation should be performed in combination and actively for patients with PHNEC or recurrence to get the best effectiveness; they might extend the disease-free and overall survival.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권12호
• /
• pp.4795-4800
• /
• 2014

Background: Few studies have directly compared clinical efficacy and safety among Chinese herb injections (CHIs) for gastric cancer (GC). The present study aimed to compare CHIs combined with FOLFOX regimens for GC to show which provides the best CHIs results. Materials and Methods: 9 electronic databases and 6 gray literature databases were comprehensive searched in April 20, 2013. According to inclusion and exclusion criteria, two reviewers independently selected and assessed the included trials. The risk of bias tool described in the Cochrane Handbook version 5.1.0 and CONSORT statement were used to assess the quality of the trials. All calculations and graphs were performed and produced using ADDIS 1.16.5 software. Results: A total of 541 records were searched and 38 RCTs met the inclusion criteria (2,761 participants), involving 10 CHIs. The results of network meta-analysis showed that compared with FOLFOX alone, combinations with Kanglaite, Astragalus polysaccharides, Cinobufacini, or Yadanziyouru injections could furthest strengthen ORR, improve the quality of life, reduce nausea and vomiting, and reduce the incidence of leukopenia (III-IV). Conclusions: Kanglaite injection, Astragalus polysaccharides injection, Yadanziyouru injection were superior to other CHIs in clinical efficacy and safety for GC. The conclusions now need to be confirmed by large sample size direct head-to-head studies.