• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권2호
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• pp.52-58
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• 2018

Dry socket, also termed fibrinolytic osteitis or alveolar osteitis, is a complication of tooth exodontia. A dry socket lesion is a post-extraction socket that exhibits exposed bone that is not covered by a blood clot or healing epithelium and exists inside or around the perimeter of the socket or alveolus for days after the extraction procedure. This article describes dry socket lesions; reviews the basic clinical techniques of treating different manifestations of dry socket lesions; and shows how microscope level loupe magnification of $6{\times}$ to $8{\times}$ or greater, combined with co-axial illumination or a dental operating microscope, facilitate more precise treatment of dry socket lesions. The author examines the scientific validity of the proposed causes of dry socket lesions (such as bacteria, inflammation, fibrinolysis, or traumatic extractions) and the scientific validity of different terminologies used to describe dry socket lesions. This article also presents an alternative model of what causes dry socket lesions, based on evidence from dental literature. Although the clinical techniques for treating dry socket lesions seem empirically correct, more evidence is required to determine the causes of dry socket lesions.

• 수면정신생리
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• 제28권1호
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• pp.6-12
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• 2021

Insomnia is one of the most common sleep disorders experienced by modern people, and treatment is often not adequate due to various limitations. Digital therapeutics for insomnia are expected to play a revolutionary role in supplementing and satisfying unmet needs in real-world clinical treatment. Digital therapeutics for insomnia were developed based on cognitive-behavioral therapy for insomnia, which is the first standard treatment for insomnia. The effectiveness of digital therapeutics for insomnia developed by several companies has been proven through well-designed clinical research. Various approaches have been used for practical application of digital therapeutics for insomnia. Thus far, meaningful results have been drawn, but there are areas that need to be improved upon based on real-world evidence. Sleep researchers need to validate the safe and effective application of digital therapeutics for the treatment of insomnia.

• 임상간호연구
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• 제20권3호
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• pp.337-347
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• 2014

Purpose: Deep Vein Thrombosis (DVT) is the cause of fatal diseases such as pulmonary embolism, due to a prolonged immobility, surgery, paralysis, and injuries. This study aimed to develop an evidence-based practice guideline for DVT prevention and apply it to patients with surgery in diverse nursing sites in South Korea. Methods: A 24-staged processes of adaptation was carried out on the basis of "adaptation of nursing practical guidelines" developed by Gu et al., in 2012. Results: Developed nursing guidelines of DVT prevention are composed of 79 recommendations in 8 domains. The extent and ratings of each recommendation with its evidence were addressed along with the background information. Conclusion: The developed DVT prevention guideline is necessary to be added to the evidence-based practice guidelines for the fundamentals of nursing practice. The developed guideline is needed to be disseminated to diverse nursing clinical settings in order to prevent DVT and enhance the quality nursing care.

• 대한한의학회지
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• 제38권3호
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• pp.143-159
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• 2017

Objectives: The aim of this study was to investigate the current status of and seek for measures to activate Korean medicine in stroke care. Methods: This is an e-mail survey targeting the members of Korean medical doctors registered at the association of Korean medicine. The project team of the society of stroke on Korean medicine for the development of clinical practice guideline for stroke has devised the items for the questionnaire. The survey was conducted for 15 days in November 2016. Results: The percentage of the respondents who have treated patients with stroke for the past month was 11.2% in the acute phase, 20.5% in the convalescent phase, and 32.4% in the chronic phase. Approximately 80% of the respondents answered they had a decrease in the number of patients compared to 10 years ago, regardless of the stroke phase. Most of the respondents were using Western medicine together with traditional Korean medicine for physical examination. Acupuncture and herbal medicine were the main therapeutic interventions. The two measures chosen by the most respondents to activate the Korean medicine usage for stroke care were the expansion of the insurance coverage (34.9%) and the generation of evidence on the effectiveness of traditional Korean medicine (25.1%) Conclusion: It is necessary to actively show the role of the Korean medicine through the establishment of the evidence on the effectiveness of Korean medicine and the promotion based on the evidence. In addition, optimal treatment methods should be derived based on the traditional knowledge and modern scientific research and the methods should be educated to every Korean medical clinics and hospitals so that they can be implemented in clinical practice. At the same time, the government should provide policy support to ensure that the optimal treatment can be timely and appropriately implemented.

• Journal of Acupuncture Research
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• 제29권3호
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• pp.19-28
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• 2012

Objectives : The aim of this study is to evaluate present clinical evidence of oriental medical treatment for cancer in Korea. Method : A search was performed in the Korean Studies Information, Korea Institute of Science and Technology Information, KoreaMed, Oriental Medicine Advanced Searching Integrated System, National Assembly Library, RISS4u, DBPIA, and Oasis using the keyword 'cancer', 'leukemia', 'malignant tumor', 'lymphoma', 'multiple myeloma', 'melanoma'. The search period spanned between Jan 1, 1980~June 30, 2011 and the results were analyzed and evaluated according to the publication date, journal, method of treatment, type of study, and the primary outcome. Randomized clinical trials (RCTs) and Non randomized clinical trial(NRCT) were reviewed separately. Result : The results yielded 133 trials during the period of Jan 1, 1980~June 30, 2011. Most of the trials were concerned with lung cancer and 94 of the trials were simple case studies or case series studies. 61 trials used herbal Formula/herbal medicine as the primary method of treatment. A total of 4 RCTs existed compared to only one NRCT. Conclusion : The use of oriental medicine for the treatment of cancer is gaining popularity in the field of medical scientific research. However most of the studies that have been published up to date are mostly case studies or case series studies, and RCT/NRCT are rare. In order to provide appropriate evidence regarding the effectiveness of oriental medicine in the treatment of cancer, more rigorous and well-designed studies are warranted.

• 대한한의학회지
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• 제36권1호
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• pp.1-8
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• 2015

Objectives: This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the patients with post-stroke spasticity. Methods: Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on post-stroke spasticity, compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions: One systematic review and 7 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of electroacupuncture treatment for post-stroke spasticity. However, it did not show any sufficient evidence to treat the patients with post-stroke spasticity with the sole acupuncture. The moderate evidence was presented that over 3 times of the electroacupuncture treatments with 1-100 Hz frequency should be performed every week on the acupoints, such as LI11, LI10, TE5, LI4, ST36, GB34, ST40, or LR3, for 20-30 minutes. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. Finally, there was a moderate evidence to support safety of acupuncture treatment for post-stroke spasticity.

• 대한한의학회지
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• 제38권3호
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• pp.13-29
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• 2017

Objectives: The objective of this review is to investigate the use of conventional Western medicine (WM) and complementary and alternative medicine (CAM) on leg cramps. Leg cramps are the occurrence of muscular spasm in the leg muscles which occur frequently in the elderly and are frequently observed in the clinical field. Methods: Relevant clinical studies were searched from five medical databases including PubMed, KISS, RISS, OASIS, and J-STAGE. Systematic review, clinical studies, and clinical practice guideline were included in this review. Results: In total, 27 clinical studies, 9 systematic review and meta-analysis, and 1 clinical practice guideline met the inclusion criteria. Included studies were classified and analyzed according to the type of intervention. Studies on quinine and magnesium have been most studied in WM and CAM, respectively. Although quinine shows some clinical effects on leg cramps, however, the risk of side effects are suggested. In addition, magnesium failed to improve the clinically significant effects in most studies. Five case reports using Oriental herbal medicine (OHM) were included and OHMs were effective in improving leg cramps without side effects, however, the quality of evidence was low. Clinical studies on other interventions were lacking. Conclusions: The results of this study indicate that there is no definite treatment standard for leg cramps until now, and there are limitations such as low level of evidence and side effects for each treatment. OHM can be an effective alternative to conventional intervention on leg cramps, therefore, related clinical studies are needed.

• Journal of Genetic Medicine
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• 제8권1호
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• pp.28-34
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• 2011

대부분의 의사들은 임상시험을 치료약제개발 후 의료현장에서 사용하기 위해 진행되는 과정으로 생각할 것이다. 실험실에서 개발된 기술이 진단검사로써 도입되기 위해서는 치료약제의 경우와 유사한 임상시험 과정을 거쳐 그 안정성과 유효성에 대한 검증을 필요로 한다. 치료약제의 효과검증에서 가장 우수한 근거를 얻을 수 있는 연구방법은 무작위대조연구 방법이지만, 이를 검체진단검사에 그대로 적용하기는 어렵다. 검체진단검사의 경우 비교연구가 진단정확도의 검증을 위해 현실적으로 사용할 수 있는 연구방법이지만 대상군의 모집 방법과 구분 방법, 질환대상자의 질환 심각도, 참고표준의 선택과 적용, 눈가림 여부 등 여러 요인들이 진단정확도 지표에 직접적인 영향을 주기 때문에, 좋은 근거수준의 연구결과를 얻기 위해서는 이러한 요소들을 고려한 잘 고안된 연구디자인이 중요하다. 또한 검체진단검사는 치료약제의 경우와 달리 결과를 얻기 위한 검사과정이 사용자인 일선 검사실에 의해 계속 생산되어야 하고, 검사의 개발과 발전의 속도가 빠르며, 일선검사실이 최종사용자이자 개발자인 경우가 흔하다는 특성이 있다. 저자들은 이러한 검사의 특성을 고려하여 검사법 자체의 수행능력에 대한 검증으로부터 검사법 성능평가를 위한 질환확진군과 정상군에 대한 비교연구, 일련의 질환의심자 대상의 진단정확도 평가와 임상 효과성 평가, 도입 후 일상감시로 이어지는 임상시험의 진행단계를 제안하고자 한다.

• 성인간호학회지
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• 제25권3호
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• pp.250-262
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• 2013

Purpose: This study was designed to develop, to implement and evaluate a fever management nursing protocol for adult patients. Methods: This study was conducted through seven steps following both the guideline development procedures of the Scottish Intercollegiate Guidelines Network and the Model of the Asan Medical Center Evidence-Based Practice, as follows: 1) identifying the clinical needs and composition of the protocol development group; 2) identifying and evaluating the evidence; 3) assessing the level of evidence and grading recommendations; 4) forming a protocol; 5) evaluating the protocol using an expert group validity test and identifying barriers to its implementation; 6) protocol development; and 7) evaluation of practical improvement measures following implementation of the protocol. Results: The evidence-based protocol for fever management in adult patients was completed and includes five domains and 15 items. The protocol had good content validity (CVI=.90) and nursing practice could be improved after implementation of the protocol. Conclusion: This nursing protocol can be used as a guide for nursing in febrile adult patients. We recommend that further guidelines be updated in an interdisciplinary manner in order to foster local adaptation of the best clinical practices.

• 대한의용생체공학회:의공학회지
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• 제45권2호
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• pp.81-89
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• 2024

Purpose : This study conducted a systematic review and meta-analysis to evaluate the clinical effectiveness of laser acupuncture for each condition using information from laser acupuncture trials registered on clinicaltrials.gov from January 2013 to June 2023. Methods : We quantitatively and qualitatively analysed the results of 16 clinical trials of laser acupuncture whose research results were confirmed. A risk of bias assessment was also carried out to assess the quality of each clinical trial. Results : A meta-analysis including three clinical trials was conducted to evaluate the comparative effectiveness of laser acupuncture and sham laser acupuncture in reducing pain and found that the laser acupuncture group had a statistically significant reduction in pain compared with the sham laser acupuncture group. In addition, 11 of the 13 trials not included in the meta-analysis showed a positive effect of laser acupuncture. Conclusion : Although laser acupuncture has a long history of clinical use and a lot of research, there is still some scepticism due to the lack of a clear mechanism of action and inconsistent reports of clinical effectiveness. In addition, there is a significant lack of systematic reviews of clinical evidence for major disease specific, and ongoing research is needed to establish an objective evidence base for the clinical effectiveness of laser acupuncture.