• The Journal of Internal Korean Medicine
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• v.40 no.6
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• pp.1081-1100
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• 2019

Objectives: This study is an overview of the meta-analysis and systematic review of randomized controlled trials investigating the clinical effectiveness and safety of pharmacopuncture for patients with stroke. Methods: Core electronic databases were searched from their inception to 21 May 2019. A measurement tool to assess systematic reviews (AMSTAR 2) was applied to screen high-quality studies. The results of these studies were summarized, and additional meta-analysis was conducted. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the certainty of evidence. Results: Sixteen studies met eligibility criteria. Four were excluded owing to insufficiency of AMSTAR 2 or low data reliability. The finally selected 12 studies were about pharmacopuncture using either a single herb extract, such as Dengzhan xixin, Sanch, Ginkgo biloba, or Acanthopanax, or a mixture of herbs, such as Compound danshen, Shenxiong, Xingnaojing, or Mailuoning. Most of the patients were from China, with acute ischemic stroke. All the studies using a pharmacopuncture versus a non-pharmacopuncture design reported the significant superiority of pharmacopuncture on every outcome measure. On the other hand, in a few studies, pharmacopuncture was inferior to active control in improving neurological deficit. Few studies reported adverse events. Conclusions: It is difficult to apply the results of this study directly to Korea, because the level of evidence is generally low and the clinical settings and social acceptance of pharmacopuncture therapy differ in Korea and China. Further studies are warranted to confirm the domestic applicability of evidence generated in China and to create evidence that supports the domestic situation.

• Korean Journal of Social Welfare
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• v.65 no.3
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• pp.107-130
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• 2013

This study conducted a meta-analysis on the studies related with job satisfaction of social workers. For data analysis, journals, theses, and dissertations published between 1990 and 2013 were reviewed systematically. Through this process, this study calculated average effect size of each variable and explored moderator variables. The study results were as follows. First, this study significantly identified 27 variables related with job satisfaction of social workers. Second, the results indicated that large effect size variables included empowerment, organizational climates, supervision, relationship with boss, leadership, social support, work environment, reward system factor, self-esteem, work autonomy. Third, moderator analyses were conducted utilizing characteristics of organization. Moderate effects were identified in the following variables including role conflict, specialization, recognition, promotion, relationship with peer, supervision. Finally, the implications of the study findings were discussed.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.6123-6128
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• 2015

Background: The aim of this study was to analyze the prognostic implications of pretreatment circulating endothelial cells (CECs) and circulating endothelial progenitor cells (CEPCs) for the survival of patients with lung cancer. Materials and Methods: Relevant literature was identified using Medline and EMBASE. Patient clinical characteristics, overall survival (OS) and progression-free survival (PFS) together with CEC and CEPC positive rates before treatment were extracted. STATA 12.0 was used for our analysis and assessment of publication bias. Results: A total of 13 articles (8 for CEC and 5 for CEPC, n=595 and n=244) were pooled for the global meta-analysis. The odds ratio (OR) for OS predicted by pretreatment CECs was 1.641 [0.967, 2.786], while the OR for PFS was 1.168 [0.649, 2.100]. The OR for OS predicted by pretreatment CEPCs was 12.673 [5.274, 30.450], while the OR for PFS was 4.930 [0.931, 26.096]. Subgroup analyses were conducted according to clinical staging. Odds ratio (OR) showed the high level of pretreatment CECs only correlated with the OS of patients with advanced lung cancer (stage III-IV). Conclusions: High counts of CECs seem to be associated only with worse 1-year OS in patients with lung cancer, while high level of pretreatment CEPCs correlate with both worse PFS and OS.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5573-5578
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• 2015

Background: A systematic review and meta-analysis were performed to compare the post-recurrence survival with hepatic re-resection versus transarterial chemoembolization (TACE) for recurrent hepatocellular carcinoma (HCC) after initial resection. Materials and Methods: All relevant papers were searched via PubMed, EMBASE, and Cochrane Library databases. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Subgroup analysis was performed according to country. Sensitivity analysis was performed in studies which clearly reported the recurrent regions, in moderate/high-quality studies, in studies published in full-text form, and in studies published after 2005. Results: In total, twelve papers were included in our study. Five and seven of them were of moderate- and poor-quality, respectively. The overall meta-analysis demonstrated a statistically significantly higher post-recurrence survival in the hepatic re-resection group than in those undergoing TACE (HR=0.64, 95%CI=0.52-0.79, P<0.0001). Heterogeneity was statistically significant and statistical significance remained in the subgroup analysis. Sensitivity analyses were also consistent with the overall analysis. Conclusions: Hepatic re-resection might provide a better post-recurrence survival than TACE for recurrent HCC after initial resection. However, considering the low quality of published studies and the potential bias of treatment selection, further randomized trials should be warranted to confirm these findings.

• Journal of Korean Neurosurgical Society
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• v.63 no.4
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• pp.477-486
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• 2020

Objectives : Due to recent developments and the wide application of percutaneous transforaminal discectomy (PTED) in China, we herein compare its clinical effects with microendoscopic discectomy (MED) for the treatment of lumbar disc herniation in terms of recurrence and revision rates. Methods : Six databases, namely, PubMed, EMBASE, Cochrane Library, Ovid, China National Knowledge Infrastructure and Wanfang, were searched by computer. The literature was screened according to inclusion and exclusion criteria, and the quality of the included literature was evaluated. After extracting the data from the papers, Review Manager 5.2 software (Cochrane Collaboration, Oxford, UK) was applied to analyze these data. Finally, sensitivity and publication bias analyses of the results were conducted. Results : A total of 12 studies consisting of 2400 patients were included in this meta-analysis. A comparison of PTED with MED revealed higher postoperative recurrence and postoperative revision rates for PTED (odds ratio [OR] recurrence, 1.60; 95% confidence interval [CI], 1.01 to 2.53; p=0.05 and OR revision, 1.77; 95% CI, 1.18 to 2.64, p=0.006). Conclusion : PTED has a number of advantages because it is a minimally invasive surgery, but its recurrence and revision rates are higher than MED. Therefore, MED should not be completely replaced by PTED.

• Investigative Magnetic Resonance Imaging
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• v.19 no.1
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• pp.37-46
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• 2015

Purpose: This report compared the diagnostic effectiveness between ultrasmall superparamagnetic iron oxide (USPIO) and gadolinium (Gd) based magnetic resonance imaging (MRI) for differentiation of axillary status in breast cancer patients. Materials and Methods: The present authors performed a meta-analysis of previous studies that compared USPIO or Gd based MRI with histological diagnosis after surgery or biopsy. We searched PubMed, EMBASE, Cochrane Library, ScienceDirect, SpringerLink, Ovid databases and references of articles to identify studies reporting data until December 2013. Pooled sensitivity and specificity were calculated for every study; summary receiver operating characteristic and subgroup analysis was done. Analyses of study quality and heterogeneity were also assessed. Results: There were 14 publications that met the criteria for inclusion in our meta-analysis. USPIO based MRI showed 0.83 (95% CI: 0.75-0.89) and 0.97 (95% CI: 0.94-0.98) for pooled sensitivity and specificity, respectively. Gd based MRI represented pooled sensitivity and specificity of 0.61 (95% CI: 0.55-0.67) and 0.90 (95% CI: 0.87-0.92) for each. Overall weighted area under the curve for USPIO and Gd based MRI were 0.9563 and 0.9051, respectively. Conclusion: USPIO based MRI had a tendency toward high pooled sensitivity and specificity in detection of axillary metastases for breast cancer. This result may mean that USPIO based MRI could be used as complementary modality to differentiate axillary status more precisely, and assist in the decision-making process regarding possible invasive procedures, such as sentinel node biopsy.

• Journal of Gastric Cancer
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• v.15 no.4
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• pp.256-261
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• 2015

Purpose: Gastric cancer is the third leading cause of cancer-related mortality, with the incidence and mortality being higher in men than in women. Various studies have shown that eating carrots may play a major role in the prevention of gastric cancer. We conducted a meta-analysis to determine the relationship between carrot consumption and gastric cancer. Materials and Methods: We searched multiple databases including PubMed, Cochrane Library, Scopus, ScienceDirect, and Persian databases like Scientific Information Database (SID) and IranMedx. The following search terms were used: stomach or gastric, neoplasm or cancer, carcinoma or tumor, and carrot. Statistical analyses were performed using Comprehensive Meta Analysis/2.0 software. Results: We retrieved 81 articles by searching the databases. After considering the inclusion and exclusion criteria, 5 articles were included in this study. The odds ratio (OR) obtained by fixed effects model showed that a 26% reduction in the risk of gastric cancer has been associated with the consumption of carrots) OR=0.74; 95% confidence interval=0.68~0.81; P<0.0001). According to funnel graph, the results showed that the possibility of a publication bias does not exist in this study. Conclusions: The findings of this study showed an inverse relationship between the consumption of carrots and the risk of gastric cancer.

• Journal of Korean Academy of Nursing
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• v.49 no.6
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• pp.655-676
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• 2019

Purpose: The purpose of this study was to investigate the effects of aromatherapy on sleep quality. Methods: This is a systematic review of randomized controlled trial studies (PROSPERO registration number CRD42017064519). In this study, the PICO were adults and the elderly, aromatherapy intervention, a comparative intervention with the control and placebo oil groups, and sleep. The selected articles were in English, Korean, and Chinese. Results: The results of the meta-analysis showed that the effect sizes of the experimental group were 1.03 (n=763, SMD=1.03, 95% CI 0.66 to 1.39) (Z=5.47, p<.001). In the aromatherapy intervention group, the effect size of sleep was statistically significant (Q_B=9.39, df=2, p=.009), with a difference of 0.77 for inhalation, 1.12 for oral intake and 2.05 for massage. A post-analysis showed that the effect of massage on sleep was significantly greater than the inhalation method. The regression coefficient of the intervention period, B=0.01 (Z=1.43, p=.154), also showed that the longer the intervention period, the larger the effect size; however, it was not statistically significant. Conclusion: A total of 23 literature analyses showed that aromatherapy is effective in improving quality of sleep, and the massage method is more effective in improving quality of sleep than the inhalation method. A meta-ANOVA showed that the aromatherapy intervention affected the high heterogeneity of the effect size. Thus, future research with stricter control in methods and experimental procedures is necessary.

• Journal of Ginseng Research
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• v.34 no.4
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• pp.342-347
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• 2010

Ginseng is one of the most-widely used herbal remedies. This systematic review evaluates the current evidence for its use in the reducing blood pressure (BP) in patients with hypertension. Systematic searches of 12 electronic databases were conducted without language restrictions. All randomized clinical trials (RCTs) of ginseng as a treatment for hypertension were candidates for inclusion. Methodological quality was assessed using the Cochrane risk of bias. Five RCTs met the inclusion criteria. The risk of bias was low in most of the trials. Four of the included RCTs compared the effectiveness of ginseng to placebo. The meta-analysis of these data failed to show a statistically significant acute effect on systolic BP (SBP) or diastolic BP (DBP). However, subgroup analyses showed beneficial effects of Korean red ginseng (KRG) on both SBP (n=54, mean difference [MD], -6.52; 95% confidence interval [CI], -9.99 to -3.04; p=0.0002) and DBP (n=54, MD, -5.21; 95% CI, -7.90 to -2.51; p=0.0001). Two RCTs tested the long-term effects of ginseng for BP for 24hours. One of these trials failed to show any benefits of KRG compared to no treatment, and the other failed to show superior effects of North American ginseng compared to placebo. Adverse events with ginseng were none in one trial or not assessed. Collectively, these RCTs provide limited evidence for the acute effectiveness of KRG in the treatment of high BP. The total number of RCTs included in the analysis and the total sample size were insufficient to draw definitive conclusions. More rigorous studies are warranted.

• Journal of Korean Academy of Nursing
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• v.48 no.2
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• pp.123-142
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• 2018

Purpose: This study was conducted to evaluate the effectiveness of non-pharmacologic interventions in chemotherapy-induced peripheral neuropathy (CIPN). Methods: PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean databases (Until August 2017) were searched. The main search strategy combined terms for peripheral neuropathy and presence of neoplasms. The risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies and the Risk of Bias Assessment tool for non-randomized studies. To estimate the effect size, a meta-analysis of the studies was performed using the Rev Man 5.3 program of the Cochrane Library random-effects models were used in the analyses. Results: Twenty-two studies with a total of 954 participants met the inclusion criteria. Of the 22 studies, 12 were used to estimate the effect size of the non-pharmacologic interventions. The non-pharmacologic interventions used in patients with CIPN were exercise, acupuncture, massage, and foot bath. The acupuncture significantly reduced CIPN symptoms and signs (d=-0.71) and CIPN pain (d=-0.73) (p<.001). Massage and foot bath were also effective in reducing CIPN symptoms (d=-0.68; 95% CI=-1.05, -0.30; p<.001; $I^2=19%$).Exercises were effective in improving muscle strength and endurance(d=-0.55) and quality of life (d=-2.96), but they were not significantly effective in improving CIPN. Conclusion: Although these results provide little evidence of the effectiveness of acupuncture, massage, and foot bath in the treatment of CIPN, they suggest that these interventions can reduce CIPN symptoms in patients with cancer. However, the findings of this study should be interpreted with caution as there is a relative lack of data in this field, and additional well-designed studies are needed. PROSPERO registration: CRD42017076278.