• Tuberculosis and Respiratory Diseases
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• 제87권1호
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• pp.91-99
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• 2024

Background: Tuberculous pleural effusion (TPE) and parapneumonic effusion (PPE) are often difficult to differentiate owing to the overlapping clinical features. Observational studies demonstrate that the ratio of lactate dehydrogenase to adenosine deaminase (LDH/ADA) is lower in TPE compared to PPE, but integrated analysis is warranted. Methods: We conducted a systematic review to evaluate the diagnostic accuracy of the LDH/ADA ratio in differentiating TPE and PPE. We explored the PubMed and Scopus databases for studies evaluating the LDH/ADA ratio in differentiating TPE and PPE. Results: From a yield of 110 studies, five were included for systematic review. The cutoff value for the LDH/ADA ratio in TPE ranged from <14.2 to <25. The studies demonstrated high heterogeneity, precluding meta-analysis. Quality Assessment of Diagnostic Accuracy Studies Tool 2 assessment revealed a high risk of bias in terms of patient selection and index test. Conclusion: LDH/ADA ratio is a potentially useful parameter to differentiate between TPE and PPE. Based on the limited data, we recommend an LDH/ADA ratio cutoff value of <15 in differentiating TPE and PPE. However, more rigorous studies are needed to further validate this recommendation.

• 산경연구논집
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• 제13권8호
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• pp.1-7
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• 2022

Purpose: The present study concentrates on the issues that affected the employees directly and acted as stress factors. These stress factors affect how the employees perform while undertaking their duties. Furthermore, this study evaluated how the involvement of the corporate counsel affected the company by enhancing the productivity of the employees. Research design, data and methodology: The research design of this research is a literature content analysis and method for data handling should be described, and the resultant combination of the studies should include the consistency measures for every meta-analysis. Specify any risk assessment of bias that may impact the cumulative evidence, such as the publication bias and the selective reporting within studies. Results: The finding shows that change in the location of employees' organizational restructuring and the introduction of new technologies also contributed to significant organizational stress factors. These results show a substantial correlation between the magnitude of the adjustments' effects on employees' performance. Conclusions: The current study strongly concludes that counselors, through their prowess, can analyze and evaluate the stress factors that are evident among the employees and in the organization. Some of these factors may be office layout, organizational codes of ethics, organization rules, and employees' personal challenges.

• Imaging Science in Dentistry
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• 제52권1호
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• pp.1-9
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• 2022

Purpose: This systematic review aimed to compare assessments of the healing of periapical endodontic surgery using conventional radiography and cone-beam computed tomography (CBCT). Materials and Methods: This review of clinical studies was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. All articles published from 1990 to March 2020 pertaining to clinical and radiographic healing assessments after endodontic surgery using conventional radiography and CBCT were included. The question was "healing assessment of endodontic surgery using cone-beam computed tomography." The review was conducted by manual searching, as well as undertaking a review of electronic literature databases, including PubMed and Scopus. The studies included compared radiographic and CBCT assessments of periapical healing after periapical endodontic surgery. Results: The initial search retrieved 372 articles. The titles and abstracts of these articles were read, leading to the selection of 73 articles for full-text analysis. After the eligibility criteria were applied, 11 articles were selected for data extraction and qualitative analysis. The majority of studies found that CBCT enabled better assessments of healing than conventional radiography, suggesting higher efficacy of CBCT for correct diagnosis and treatment planning. A risk of bias assessment was done for 10 studies, which fell into the low to moderate risk categories. Conclusion: Three-dimensional radiography provides an overall better assessment of healing, which is imperative for correct diagnosis and treatment planning.

• Journal of Korean Neurosurgical Society
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• 제64권3호
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• pp.418-426
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• 2021

Objective : A role of diffusion-weighted imaging (DWI) in the diagnosis of cerebral venous thrombosis (CVT) is not well-understood. This study evaluates the effectiveness of DWI in the diagnosis of CVT. Methods : Literature search was conducted in electronic databases for the identification of studies which reported the outcomes of patients subjected to DWI for CVT diagnosis. Random-effects meta-analyses were performed to achieve overall estimates of important diagnostic efficiency indices including hyperintense signal rate, the sensitivity and specificity of DWI in diagnosing CVT, and the apparent diffusion coefficient (ADC) of DWI signal areas and surrounding tissue. Results : Nineteen studies (443 patients with 856 CVTs; age 40 years [95% confidence interval (CI), 33 to 43]; 28% males [95% CI, 18 to 38]; symptom onset to DWI time 4.6 days [95% CI, 2.3 to 6.9]) were included. Hyperintense signals on DWI were detected in 40% (95% CI, 26 to 55) of the cases. The sensitivity of DWI for detecting CVT was 22% (95% CI, 11 to 34) but specificity was 98% (95% CI, 95 to 100). ADC values were quite heterogenous in DWI signal areas. However, generally the ADC values were lower in DWI signal areas than in surrounding normal areas (mean difference-0.33×10-3 ㎟/s [95% CI, -0.44 to -0.23]; p<0.00001). Conclusion : DWI has a low sensitivity in detecting CVT and thus has a high risk of missing many CVT cases. However, because of its high specificity, it may have supporting and exploratory roles in CVT diagnosis.

• 한방재활의학과학회지
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• 제25권4호
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• pp.41-46
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• 2015

Objectives This systematic review will analyse randomised controlled trials (RCTs) of manual therapy in patients with temporomandibular disorders (TMDs) to evaluate the efficacy of this approach. Methods RCTs will be identified in the following ten databases based on searches starting with their inception: MEDLINE, EMBASE, CENTRAL, four Korean databases as KoreaMed, DBPIA, NDSL, and RISS and three Chinese databases as CNKI, VIP and Wanfang. The quality of these studies will be analysed using the Cochrane risk of bias. A meta-analysis will be conducted, and subgroup analysis will be considered if comparatively large heterogeneity is detected. Conclusions We plan to publish this systematic review in a peer-reviewed journal. Findings from this review may contribute to the treatment process in clinical situations. Trial registration number: PROSPERO 2015: CRD42015024090

• Asian Pacific Journal of Cancer Prevention
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• 제15권10호
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• pp.4265-4269
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• 2014

Purpose: This study aimed at summarizing epidemiological evidence of the association between gestational diabetes mellitus (GDM) and subsequent risk of cancer. Materials and Methods: We searched Medline, Embase, Cancer Lit and CINAHL for epidemiological studies published by February 1, 2014 examining the risk of cancer in patients with history of GDM using highly inclusive algorithms. Information about first author, year of publication, country of study, study design, cancer sites, sample sizes, attained age of subjects and methods used for determining GDM status were extracted by two researchers and Stata version 11.0 was used to perform the meta-analysis and estimate the pooled effects. Results: A total of 9 articles documented 5 cohort and 4 case-control studies containing 10,630 cancer cases and 14,608 women with a history of GDM were included in this review. Taken together, the pooled odds ratio (OR) between GDM and breast cancer risk was 1.01 (0.87-1.17); yet the same pooled ORs of case-control and cohort studies were 0.87 (0.71-1.06) and 1.25 (1.00-1.56) respectively. There are indications that GDM is strongly associated with higher risk of pancreatic cancer (HR=8.68) and hematologic malignancies (HR=4.53), but no relationships were detected between GDM and other types of cancer. Conclusions: Although GDM increases the risk of certain types of cancer, these results should be interpreted with caution becuase of some methodological flaws. The issue merits added investigation and coordinated efforts between researchers, antenatal clinics and cancer treatment and registration agencies to help attain better understanding.

• 자원ㆍ환경경제연구
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• 제29권2호
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• pp.247-270
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• 2020

통계적 생명가치는 환경정책의 편익 산정에 있어 매우 중요한 역할을 한다. 예를 들어 대기오염물질의 감소에 따른 건강 편익의 최종적인 화폐가치화 단위로 활용되며 이는 비용편익 분석의 기초가 된다. 통계적 생명가치는 사망위험 감소를 위해 사회의 구성원이 지불하고자 하는 화폐적 가치로 정의될 수 있다 따라서 통계적 생명가치는 각 사회를 구성하고 있는 구성원의 특성에 따라 결정된다. 본 연구는 웹 설문조사를 통해 수집된 총 3,081명의 응답자를 질문의 형태에 따라 두 개의 표본으로 분리하여 선택실험법을 적용하였다. 추정결과 총 1,528명의 표본 집단의 자료를 통해 도출된 약 13억 원의 통계적 생명가치가 가장 적절한 것으로 나타났으며, 이는 국내 선행연구를 활용한 메타분석의 결과와 유사하다. 또한 응답자들은 사망위험을 감소시키기 위해 정부의 정책비용에 대한 지불보다는 개인 차원의 예방에 비용을 지불하는 것을 선호하는 것으로 나타났다.

• Pediatric Infection and Vaccine
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• 제31권1호
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• pp.12-24
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• 2024

본세계적으로 소아 코로나바이러스 감염 2019 (COVID-19) 환자 수가 질병 초기와 비교하여 증가하고 있으며, 이는 고도로 전염성이 있는 중증 급성 호흡기 증후군 코로나바이러스 변이와 성인 COVID-19 백신 접종 증가와 관련이 있다. 본 연구는 청소년 대상 COVID-19 백신 접종의 무작위 임상시험 (randomized controlled trial, RCT) 후향적 관찰연구를 대상으로 신속 체계적 문헌고찰과 메타 분석을 수행했다. 체계적 문헌고찰 결과, 17개의 연구가 최종적으로 포함되었다. 메타 분석 결과, 청소년 대상 예방접종은 후향적 관찰 연구에서 COVID-19 감염을 예방하는 데 유의미하게 효과적이었으나 (risk ratio [RR], 0.29; 95% confidence interval [CI], 0.22-0.37; I²=100%), RCT보다 COVID-19 감염을 예방하는 효과가 낮았다 (RR, 0.05; 95% CI, 0.01-0.27). 5개의 후향적 관찰 연구에서, 국민 10만 명당 심근염 및/또는 심낭염 비율은 2.33명 (95% CI, 0.97-5.61 명)이었다. 성별 및 백신 접종 횟수에 따른 하위 그룹 분석 결과, 남성 (국민 10만 명당 5.35 명) 및 두 번째 접종 (국민 10만 명당 9.71명)은 여성 (국민 10만 명당 1.09명) 및 첫 번째 접종 (국민 10만 명당 1.61명)보다 심근염 및/또는 심낭염 발생률이 유의하게 높았다. 본 연구에서는 청소년을 대상으로 mRNA COVID-19 백신을 접종하는 것은 RCT 및 관찰연구 모두에서 COVID-19에 대해 효과적이었다. 또한 청소년 대상 BNT162b2 백신의 안전성 결과를 탐색하였으며, 성별 및 백신 접종 횟수에 따른 안전성의 차이를 확인했다. 향후 mRNA COVID-19 예방접종 후 부작용 발생은 계속 모니터링할 필요가 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3917-3925
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• 2012

Background: The relationship between postmenopausal hormone therapy (HT) and invasive breast cancer has been extensively investigated, but that with breast carcinoma in situ (BCIS) has received relatively little attention. The aim of our present study was to review and summarize the evidence provided by longitudinal studies on the association between postmenopausal HT use and BCIS risk. Methods: A comprehensive literature search for articles published up to May 2012 was performed. Prior to performing a meta-analysis, the studies were evaluated for publication bias and heterogeneity. Relative risk (RR) or odds ratio (OR) values were calculated using 14 reports (8 case-control studies and 6 cohort studies), published between 1986 and 2012. Results: There was evidence of an association between ever postmenopausal estrogen use and BCIS based on a random-effects model (RR = 1.25, 95% confidence interval (CI) = 1.01, 1.55). However, we found no strong evidence of an association between ever postmenopausal estrogen combined with progesterone use and BCIS using a randomeffects model (RR = 1.55, 95% CI = 0.95, 2.51). Furthermore, our analysis showed a strong association between "> 5 years duration" of estrogen or estrogen combined with progesterone use and BCIS. Furthermore, current use of any HT is associated with increased risk of BCIS in cohort studies. Additional well-designed large studies are now required to validate this association in different populations.

• Korean Journal of Acupuncture
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• 제40권3호
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• pp.62-78
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• 2023

Objectives : This study aims to assess the impact of acupotomy on migraine through an examination of clinical studies conducted since 2015. Methods : We conducted a comprehensive search for randomized controlled trials (RCTs) and non-randomized controlled trials (nRCTs) related to acupotomy treatment for migraine, utilizing five Korean online databases (OASIS, Science ON, DBPIA, KISS, RISS), as well as four foreign online databases (CNKI, PubMed, EMBASE, Cochrane Library). We identified a total of 10 relevant studies for analysis. Participants characteristics, treatment points, combination treatments, treatment cycles or frequencies, evaluation indices, efficacy, and adverse events were analyzed. The risk of bias in the 10 RCTs was assessed using the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2.0). Results : A total of 931 participants were included in 10 studies. In the intervention group, the average duration of migraine morbidity ranged from 15.5±4.5 months to 15.9±4.2 years. Six studies based their diagnoses on the International Classification of Headache Disorders (ICHD), while five studies relied on Chinese diagnostic criteria. All studies specified the treatment area as the region exhibiting tenderness or induration on the head and neck. Treatment cycles ranged from a minimum of 2 days to a maximum of 1 week, with the number of days per treatment course varied from 5 days to 4 weeks. The diameter of acupuncture needles used varied between 0.3 mm and 1 mm. Of the eight studies specifying needle length, the shortest was 20 mm, and the longest was 40 mm. A total of eight evaluation indices were employed, with total efficacy rate (TER) and visual analogue scale (VAS) being the most frequently used. Statistically, all intervention groups showed more significant results compared to the control groups. Adverse events were reported in only two studies within the intervention group. Overall, the risk of bias assessment for the selected RCTs ranged from 'some concerns' to 'high risk of bias.' Conclusions : This study showed that acupotomy treatments for migraine were effective.