• Journal of Dental Anesthesia and Pain Medicine
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• 제22권1호
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• pp.1-10
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• 2022

Background: Inferior alveolar nerve block (IANB) is known to have a lower success rate for anesthesia in patients with irreversible pulpitis. This calls for supplementary techniques to effectively anesthetize such patients. This systematic review aimed to evaluate the published literature for determining the success rate of anesthesia induction using post-IANB intraligamentary (IL) injection in the mandibular teeth of patients with symptomatic irreversible pulpitis. The review question was, "What is the success rate of IL injection in the mandibular teeth of patients with irreversible pulpitis as a supplementary technique for endodontic treatment?" Methods: A thorough search of electronic databases and manual searches were performed. The protocol of the review was framed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and was registered in the International Prospective Register of Ongoing Systematic Reviews (PROSPERO) with a proper criterion for inclusion and exclusion of studies. The included studies were analyzed using the Cochrane Collaboration "Risk of Bias" tool. A meta-analysis that included a comparison of primary nerve block and supplemental IL injection was performed. The success rate was evaluated using the combined risk ratio (RR) with a random risk model. A funnel plot was created to measure publication bias. Results: After all analyses, four studies were included. In the forest plot representation, RRs were 3.56 (95% CI: 2.86, 4.44), which were in favor of the supplemental IL injections. Statistical heterogeneity was found to be 0%. These values suggest that supplemental IL injections provide better success rates for anesthesia. Conclusion: According to the pooled qualitative and quantitative analyses, supplemental IL injections increased anesthetic efficacy.

• 척추신경추나의학회지
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• 제17권2호
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• pp.17-25
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• 2022

Objectives This study aimed to evaluate the efficacy of manual therapy for knee meniscus injuries. Methods We searched seven electronic databases (MEDLINE, Cochrane Library, CAJ, Wanfang, RISS, ScienceON, and OASIS) to collect randomized controlled trials (RCTs) using the keywords "manual therapy OR chuna OR tuina" and "meniscus injury." Results Eleven RCTs were selected based on the inclusion criteria, and all studies were conducted in China. Five studies were meta-analyzed. The systematic review revealed a positive effect of manual therapy for knee meniscus injury. Low risk of selection, attrition, and reporting bias were demonstrated in all studies. Ten studies had a high risk of performance bias. Conclusions The systematic review reported favorable results using manual therapy for knee meniscus injury. However, this study has several limitations because of the high risk of bias. Further clinical studies and reviews with higher levels of evidence are warranted.

• 한방안이비인후피부과학회지
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• 제36권3호
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• pp.74-98
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• 2023

Objectives : This study aims to evaluate the add-on effect of herbal bath combined with acitretin in patients with psoriasis. Methods : We searched randomized controlled trials(RCTs) reporting the effect of herbal bath and acitretin combined treatment for psoriasis in 10 electronic databases from their inception to January 2023. Study collection, data extraction, and risk of bias assessment were performed by two independent researchers. Data synthesis and risk of bias evaluation was conducted using Revman 5.4. Results : Ten RCTs with 1,008 subjects were included. Herbal bath and acitretin combined treatment group showed higher average total effective rate than acitretin alone group(RR 1.39; 95% CI: 1.15-1.68, P=0.0006, I² =0%). Herbal bath and additional treatments such as phototherapy(NB-UVB) and oral herbal medicine, combined with acitretin group also showed higher average total effective rate than acitretin alone group(RR 1.81; 95% CI: 1.47-2.22, P<0.00001, I² =43%). Herbal bath and phototherapy(NB-UVB) combined with acitretin group also showed higher average total effective rate than acitretin alone group(RR 1.51; 95% CI: 1.18-1.93, P=0.0009, I² =0%). The overall risk of bias of the included studies was unclear or of high risks. Conclusions : This review showed that the add-on of herbal bath combined with acitretin treatment could be more effective than acitretin alone treatment in patients with psoriasis. However, because of few included studies, heterogeneity between studies, and insufficient quality of included studies, further well-designed RCTs are needed to confirm the add-on effect of herbal bath on psoriasis.

• 한방재활의학과학회지
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• 제34권3호
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• pp.27-41
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• 2024

Objectives This study aims to evaluate the efficacy and safety of electroacupuncture for rotator cuff disorder. Methods We searched nine online databases (PubMed, Embase, Cochrane Library, Chinese Academic Journals, Korean studies Information Service System, Rsearch Information Sharing Service, ScienceON, KMbase, Oriental Medicine Advanced Searching Integrated System) and two related journals up to April 2024 to identify randomized controlled trials that applied electroacupuncture to rotator cuff disorder. Selected studies were analyzed for risk of bias using the Cochrane risk of bias tool, and a meta-analysis was performed with RevMan version 5.4.1. Results Out of 175 studies, eleven randomized controlled trials were selected for final analysis. Most studies showed that electroacupuncture had effect on rotator cuff disorder. In the meta-analysis, electroacupuncture combined with rehabilitation treatment was significantly more effective than rehabilitation treatment alone in improving visual analog scale (p<0.00001). Almost studies did not report any side effects or adverse reactions to electroacupuncture treatment. Conclusions This systematic review suggests that electroacupuncture is an effective treatment for pain management in rotator cuff disorder. However, the lack of adverse effect reporting and a high risk of bias indicate the need for high-quality randomized controlled trials from various countries.

• 대한영상의학회지
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• 제85권2호
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• pp.297-307
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• 2024

관상동맥 질환은 죽상동맥경화(atherosclerosis)로 인해 혈관의 내강이 좁아지면서 심근허혈 또는 경색까지 유발할 수 있는 질병이다. 이런 관상동맥 질환은 조기에 진단해서 치료하면 그만큼 예후가 좋기에 정확한 진단이 환자 관리에서 매우 중요하다. 전산화단층촬영 혈관조영술(CT angiography; 이하 CTA)은 높은 해상도와 대조도를 통해 혈관의 구조 및 협착 정도를 세밀하게 평가할 수 있는 비침습적 영상 진단법이다. 여러 임상시험들이 관상동맥 질환에 대한 조기 진단과 평가에 있어 관상동맥 CTA의 유용성을 보고하였다. 최근에 관상동맥 질환이 의심되는 환자들에 대한 보다 효과적인 처치를 위해 CTA에 기반한 관상동맥 질환 진단 분류 체계인 관상동맥 질환 판독과 자료 체계(coronary artery disease-reporting and data system; 이하 CAD-RADS)가 만들어졌다. 이런 CAD-RADS는 관상동맥 CTA를 기반으로 하지만 CAD-RADS는 CTA 결과만으로 관상동맥의 정확한 상태를 해석하는 것이 어려운 경계선 범주를 포함하고 있다. 본 종설은 침습적 관상동맥 조영술 진행 여부를 결정하기에 앞서 추가검사가 필요한 경계선상 CAD-RADS범주들의 CTA의 소견과 이들에 대한 대처를 논하고자 한다.

• Korean Journal of Radiology
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• 제22권4호
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• pp.559-567
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• 2021

Objective: To evaluate the impact of multiparametric magnetic resonance imaging (mpMRI) before confirmatory prostate biopsy in patients under active surveillance (AS). Materials and Methods: This retrospective study included 170 patients with Gleason grade 6 prostate cancer initially enrolled in an AS program between 2011 and 2019. Prostate mpMRI was performed using a 1.5 tesla (T) magnetic resonance imaging system with a 16-channel phased-array body coil. The protocol included T1-weighted, T2-weighted, diffusion-weighted, and dynamic contrast-enhanced imaging sequences. Uroradiology reports generated by a specialist were based on prostate imaging-reporting and data system (PI-RADS) version 2. Univariate and multivariate analyses were performed based on regression models. Results: The reclassification rate at confirmatory biopsy was higher in patients with suspicious lesions on mpMRI (PI-RADS score ≥ 3) (n = 47) than in patients with non-suspicious mpMRIs (n = 61) and who did not undergo mpMRIs (n = 62) (66%, 26.2%, and 24.2%, respectively; p < 0.001). On multivariate analysis, presence of a suspicious mpMRI finding (PI-RADS score ≥ 3) was associated (adjusted odds ratio: 4.72) with the risk of reclassification at confirmatory biopsy after adjusting for the main variables (age, prostate-specific antigen density, number of positive cores, number of previous biopsies, and clinical stage). Presence of a suspicious mpMRI finding (adjusted hazard ratio: 2.62) was also associated with the risk of progression to active treatment during the follow-up. Conclusion: Inclusion of mpMRI before the confirmatory biopsy is useful to stratify the risk of reclassification during the biopsy as well as to evaluate the risk of progression to active treatment during follow-up.

• 대한한방부인과학회지
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• 제33권2호
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• pp.44-62
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• 2020

Objectives: The purpose of this study is to evaluate the effectiveness of herbal medicine for recovery and treatment of cervical intraepithelial neoplasia (CIN) after loop electrosurgical excision procedure (LEEP). Methods: We searched two english, one chinese and four korean database up to November 4, 2019. Randomised controlled trials (RCTs) were eligible. Primary outcome included Human papilloma virus (HPV) clearance rate and the effective ratio of treatment. And vaginal bleeding time and volume, improvement of symptoms, and recovery of wound were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Results: Of 47 screened, 10 RCTs were included. Number of participants per study ranged from 58 to 360. The studies which used HPV clearance rate as primary outcome were considered as low risk of bias. Most of the studies had considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to LEEP alone, herbal vaginal suppository combined group showed favorable results for HPV clearance in patients (5 studies, n=627, 95% CI 1.26 to 1.55, I²=75%). And compared to LEEP alone, herbal external application also showed favorable results for HPV clearance in patients (2 studies, n=252, 95% CI 1.19 to 1.61, I²=86%). Three studies reported mild and temporary adverse events, and no serious adverse events were reported. Conclusions: The studies showed that herbal medicine can significantly effective on recovery of CIN after LEEP. However, included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. In the Future, further high-quality RCTs are needed to prove effectiveness of herbal medicine for CIN after LEEP and reduce the risk of bias.

• Asian Pacific Journal of Cancer Prevention
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• 제16권10호
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• pp.4339-4345
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• 2015

Occupational exposure to wood dust is one cause of nasopharyngeal cancer (NPC); however, assessing this exposure remains problematic. Therefore, the objective of this study was to develop a semi-quantitative exposure assessment method and then utilize it to evaluate the association between occupational exposure to wood dust and the development of NPC. In addition, variations in risk by histology were examined. A case-control study was conducted with 327 newly diagnosed cases of NPC at the National Cancer Institute and regional cancer centers in Thailand with 1:1 controls matched for age, gender and geographical residence. Occupational information was obtained through personal interviews. The potential probability, frequency and intensity of exposure to wood dust were assessed on a job-by-job basis by experienced experts. Analysis was performed by conditional logistic regression and presented in odds ratio (ORs) estimates and 95% confidence intervals (CI). Overall, a non significant relationship between occupational wood dust exposure and NPC risk for all subjects was observed (ORs=1.61, 95%CI 0.99-2.59); however, the risk became significant when analyses focused on types 2 and 3 of NPC (ORs=1.62, 95%CI 1.03-2.74). The significant association was stronger for those exposed to wood dust for > 10 year (ORs=2.26, 95%CI 1.10-4.63), for those with first-time exposure at age > 25 year (ORs=2.07, 95%CI 1.08-3.94), and for those who had a high cumulative exposure (ORs=2.17, 95%CI 1.03-4.58) when compared with those considered unexposed. In conclusion, wood dust is likely to be associated with an increased risk of type 2 or 3 NPC in the Thai population. The results of this study show that semi-quantitative exposure assessment is suitable for occupational exposure assessment in a case control study and complements the information from self-reporting.

• Journal of the Korean Data and Information Science Society
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• 제27권4호
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• pp.1047-1057
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• 2016

본 연구는 남자 대학생을 대상으로 음주 동기, 음주거절효능감, 음주결과기대 및 고위험음주의 관계를 파악하고 고위험음주에 미치는 영향 요인을 분석하기 위하여 시도되었다. 본 연구의 대상자는 D광역시 소재 4년제 대학에 재학 중인 남자대학생으로 본 연구의 목적을 이해하고 연구 참여를 동의한 139명이었다. 구조화된 설문지로 일반적 특성, 음주 동기, 음주거절효능감, 음주결과기대, 음주량을 통한 고위험음주를 측정하였다. 연구결과 학년, 학과, 흡연 상태, 음주 동기 하위 영역 중 고양 동기, 음주거절효능감 하위 영역 중 사회적 압력 상황에서 음주거절효능감이 고위험음주에 영향을 주는 것으로 확인되었다. 대학생을 위한 고위험음주 예방을 위한 중재 전략을 수립할 때 학과별 특성을 고려한 맞춤형 교육이 필요하며 흡연 관리가 포함되어야 할 것이다. 고위험음주에 유의한 영향을 미치는 흡연에 대한 금연교육과 함께 음주로 인해 발생할 수 있는 부정적 측면에 대한 교육과 건전한 방법으로 정서를 조절하는 전략이 요구된다.

• 대한한방부인과학회지
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• 제24권4호
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• pp.105-113
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• 2011

Objectives: To examine the current status of clinical research in oriental medicine, and to assess 'risk of bias'(ROB) of randomized clinical trials(RCTs) in oriental medicine in Korea. Methods: Special committee for EBM, KOMS(Korean Oriental Medicine Society) reviewed 17 journals related to oriental medicine in Korea (from the first issue to May 2010), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2010), and PubMed (1966 to May 2010). Then we selected eligible RCTs in terms of oriental medicine, and assessed 'risk of bias'. Results: We reviewed 12,653 articles from the 17 journals, and 41 articles from CENTRAL and PubMed. After non-clinical articles were excluded, 1,004 articles were left. Among them, the number of eligible studies in terms of oriental medicine was 306. In these eligible studies, 130 were RCTs. Of RCTs, 69 were on acupuncture, 25 on herbal medicine. The proportion of 'unclear' is high in the criteria of 'Allocation concealment', 'Blinding of participants and personnel', 'Blinding of outcome assessment' and 'Other bias'. On the other hand, 'low' has high in the criteria of 'Incomplete outcome data' and 'Selective reporting'. Conclusions: Risk of bias on oriental medicine is unclear in terms of 'allocation concealment' and 'blinding'. For high-quality research in oriental medicine, further research should be needed on randomization and blinding in the RCTs.