• Medical Lasers
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• v.9 no.2
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• pp.159-165
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• 2020

Background and Objectives The ultimate goal in current skin rejuvenation practice is to achieve a good result with minimal pain and downtime. Nonablative skin rejuvenation (NSR) is one technique. The efficacy of the long-pulsed 1064 nm Nd:YAG laser (LPNDY) has not been assessed in NSR. Materials and Methods Three target areas were selected (bilateral cheeks and glabellar region) in six volunteer subjects. A LPNDY with an integral skin temperature monitor delivered three stacked shots to each target area (1064 nm, 12 mm spot, 13 J/cm², 1 Hz) without any skin cooling or anesthesia. The skin temperature was recorded before, during, and after each set of shots using the system monitor and in real-time using a high-sensitivity (±0.001℃) near-infrared video camera. The skin reaction was observed with the naked eye, and pain and discomfort were assessed by the subjects during and after treatment. Results The subjects reported a mild feeling of heat with no discomfort during or after the test treatments. Mild erythema was observed around the treatment areas, without noticeable edema. A series of three ascending skin temperature stepwise peaks, with a decrease in skin temperature towards the baseline after the third shot, was observed consistently. The mean temperatures for shots 1, 2, and 3 for the cheeks were 39.5℃, 42.0℃, and 44.4℃, respectively, and for the glabella, 40.8℃, 43.9℃, and 46.2℃, respectively. Similar ranges were indicated on the system integral temperature monitor. Conclusion A set of three stacked pulses with the LPNDY at a low fluence achieved ideal dermal temperatures to achieve some dermal remodeling but without any downtime or adverse events. The temperature data from the integral thermal sensor matched the video camera measurements with practical accuracy for skin rejuvenation requirements. These data suggest that LPNDY would satisfy the necessary criteria to achieve effective NSR, but further studies will be needed to assess the actual results in clinical practice.

• Medical Lasers
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• v.9 no.2
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• pp.150-158
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• 2020

Background and Objectives Low-level laser therapy (LLLT) is used widely to promote hair growth in androgenetic alopecia (AGA). This study examined the clinical efficacy and safety of a home-use LLLT device with a newly designed array of light sources and software optimized for individual types of AGA. Materials and Methods The study was a randomized, double-blind, sham device-controlled trial. Forty-eight subjects (39 men and nine women) were assigned randomly in a 2:1 ratio to use either the test device (LG Pra'L HGN1, LG electronics, Korea) or sham device. The subjects used the LLLT device three times a week for 16 weeks. Phototrichogram was used to measure the hair density and hair thickness at 0, 8, and 16-weeks. Adverse events were closely monitored. Results After 16 weeks of using the device, the test group showed a significant increase in hair density and hair thickness compared to the control. In the test group, the hair density increased 6.96 counts/cm² at eight weeks and 13.67 counts/cm² at 16 weeks from the baseline. The hair thickness increased 7.21 ㎛ at eight weeks and 11.80 ㎛ at 16 weeks compared to the baseline. Conclusion The home-use LLLT device with a novel array of light sources and an individualized program according to the types of hair loss appears to be an effective and safe treatment modality for both male and female AGA patients.

• The Journal of Internal Korean Medicine
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• v.42 no.2
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• pp.104-113
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• 2021

Introduction: The aim of this study is to report on the effectiveness of Korean medicine to improve symptoms of chemotherapy-induced peripheral neuropathy (CIPN). Some patients are treated with medication, but medications may have no effect in some patients. Korean medicine treatments have been used in such patients, but few reports exist. Case Presentation: A 58-year-old female patient with CIPN reported symptoms of bilateral limb pain and tingling sensations as well as cold sensations in bilateral lower legs and hands, fatigue, and bilateral limb weakness. To reduce the patient's symptoms, we provided Korean medical treatment, including herbal medicine (Uchashinki-hwan), acupuncture, and moxibation. To evaluate the results of this treatment, we used a numeric rating scale (NRS), the manual muscle test (MMT), the National Cancer Institute Common Toxicity Criteria for Adverse Events (CTCAE), and the European Organization for Research and Treatment of Cancer quality-of-life questionnaire about CIPN (EORTC-QLQ-CIPN20). After 49 days of treatment, the NRS scores decreased for bilateral limb pain and tingling, for bilateral lower leg and hand cold sensation, and for fatigue. The MMT results for the upper and lower extremities were improved. CTCAE Grade and EORTC QLQ-CIPN20 score were also decreased. Conclusion: According to these results, Korean medicine treatment may be considered an effective treatment for CIPN. Prospective studies are needed in the future to confirm and expand these findings.

• Journal of Chest Surgery
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• v.55 no.3
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• pp.189-196
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• 2022

Background: This study investigated the predictive value of the frailty index calculated using laboratory data and vital signs (FI-L) in patients who underwent coronary artery bypass grafting (CABG). Methods: This study included 508 patients (age 67.3±9.7 years, male 78.0%) who underwent CABG between 2018 and 2021. The FI-L, which estimates patients' frailty based on laboratory data and vital signs, was calculated as the ratio of variables outside the normal range for 32 preoperative parameters. The primary endpoints were operative and medium-term all-cause mortality. The secondary endpoints were early postoperative complications and major adverse cardiac and cerebrovascular events (MACCEs). Results: The mean FI-L was 20.9%±10.9%. The early mortality rate was 1.6% (n=8). Postoperative complications were atrial fibrillation (n=148, 29.1%), respiratory complications (n=38, 7.5%), and acute kidney injury (n=15, 3.0%). The 1- and 3-year survival rates were 96.0% and 88.7%, and the 1- and 3-year cumulative incidence rates of MACCEs were 4.87% and 8.98%. In multivariable analyses, the FI-L showed statistically significant associations with medium-term all-cause mortality (hazard ratio [HR], 1.042; 95% confidence interval [CI], 1.010-1.076), MACCEs (subdistribution HR, 1.054; 95% CI, 1.030-1.078), atrial fibrillation (odds ratio [OR], 1.02; 95% CI, 1.002-1.039), acute kidney injury (OR, 1.06; 95% CI, 1.014-1.108), and re-operation for bleeding (OR, 1.09; 95% CI, 1.032-1.152). The minimal p-value approach showed that 32% was the best cutoff for the FI-L as a predictor of all-cause mortality post-CABG. Conclusion: The FI-L was a significant prognostic factor related to all-cause mortality and postoperative complications in patients who underwent CABG.

• Clinics in Shoulder and Elbow
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• v.25 no.1
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• pp.28-35
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• 2022

Background: Given the complications involved in corticosteroid (CS) injections, subacromial platelet-rich plasma (PRP) injections may provide a valid alternative to CS in the treatment of rotator cuff (RC) tendinopathy. Methods: We retrospectively reviewed a total of 98 patients affected by RC tendinopathy who were treated with either subacromial injection of PRP or CS. The PRP group received three injections of autologous PRP at 2 weeks interval, and the CS group received one injection of CS. The Western Ontario Rotator Cuff Index (WORC) was the primary outcome measure, while the secondary outcome measures were the visual analog scale (VAS), range of motion (ROM), and need for cuff repair surgery, which were analyzed at intervals of 6, 12, and 18 months. Results: A total of 75 patients were included in the analysis (PRP, n=35; CS, n=40). The mean follow-up for PRP was 21.1±8.7 months and for CS was 33.6±16.3 months (p<0.001). Both groups showed improvement in WORC, VAS, and ROM. No significant differences were detected between the two groups in any of the primary (WORC) or secondary outcomes over 6, 12, and 18 months (all p>0.05). No adverse events were detected. Conclusions: Both treatments improved patient symptoms, but neither resulted in a significantly better outcome in this series of patients. PRP can be a safe and feasible alternative to CS, even at long-term follow-up, to reduce local and systemic effects involved with CS injections.

• Journal of Chest Surgery
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• v.55 no.6
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• pp.442-451
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• 2022

Background: This meta-analysis was conducted to evaluate the effect of fractional flow reserve (FFR) on clinical outcomes after coronary artery bypass grafting (CABG). Methods: Five online databases were searched for studies that (1) enrolled patients who underwent isolated CABG or CABG with aortic valve replacement and (2) demonstrated the effect of an FFR-guided strategy on major adverse cardiac events (MACE) after surgery based on a randomized controlled trial or adjusted analysis. MACE included cardiac death, acute myocardial infarction (MI), and repeated revascularization. The primary outcomes were all MACE outcomes and a composite of all-cause death and MI, and the secondary outcomes were the individual MACE outcomes. Publication bias was assessed using a funnel plot and the Egger test. Results: Six articles (3 randomized and 3 non-randomized studies: n=1,027) were selected. MACE data were extracted from 4 studies. The pooled analyses showed that the risk of MACE was not significantly different between patients who underwent FFR-guided CABG and those who underwent angiography-guided CABG (hazard ratio [HR], 0.80; 95% CI, 0.57-1.12). However, the risk of the composite of death or MI was significantly lower in patients undergoing FFR-guided CABG (HR, 0.62; 95% CI, 0.41-0.94). The individual MACE outcomes were not significantly different between FFR-guided and angiography-guided CABG. Conclusion: FFR-guided CABG might be beneficial in terms of the composite outcome of death or MI compared with angiography-guided CABG although data are limited.

• Journal of Chest Surgery
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• v.55 no.6
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• pp.452-461
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• 2022

Background: Extracorporeal membrane oxygenation (ECMO) can be used in patients with refractory cardiogenic shock or respiratory failure. In South Korea, the need for transporting ECMO patients is increasing. Nonetheless, information on urgent transportation and its outcomes is scant. Methods: In this retrospective review of 5 years of experience in ECMO transportation at a single center, the clinical outcomes of transported patients were compared with those of in-hospital patients. The effects of transportation and the relationship between insertion-departure time and survival were also analyzed. Results: There were 323 cases of in-hospital ECMO (in-hospital group) and 29 cases transferred to Hallym University Sacred Heart Hospital without adverse events (mobile group). The median transportation time was 95 minutes (interquartile range [IQR], 36.5-119.5 minutes), whereas the median transportation distance was 115 km (IQR, 15-115 km). Transportation itself was not an independent risk factor for 28-day mortality (odds ratio [OR], 0.818; IQR, 0.381-1.755; p=0.605), long-term mortality (OR, 1.099; IQR, 0.680-1.777; p=0.700), and failure of ECMO weaning (OR, 1.003; IQR, 0.467-2.152; p=0.995) or survival to discharge (OR, 0.732; IQR, 0.337-1.586; p=0.429). After adjustment for covariates, no significant difference in the ECMO insertion-departure time was found between the survival and mortality groups (p=0.435). Conclusion: The outcomes of urgent transportation, with active involvement of the ECMO center before ECMO insertion and adherence to the transport protocol, were comparable to those of in-hospital ECMO patients.

• Journal of Acupuncture Research
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• v.39 no.4
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• pp.283-296
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• 2022

In this study, the evidence of thread embedding acupuncture (TEA) in treating cervical radiculopathy in randomized controlled trials was investigated. We searched 16 databases up to August 22, 2022. Of the 2,644 studies retrieved, 22 randomized controlled trials (2,483 participants) were selected. Quality assessments were performed using Cochrane's risk-of-bias tool and RevMan 5.4 software. Outcome measures in the included studies typically showed TEA had a significant therapeutic effect compared with simple acupuncture and other remedies, and TEA was better than sham TEA. Catgut and polydioxanone had no difference in effectiveness, however, catgut was considered to be less safe. TEA was shown to be more therapeutic when inserted deeper into the skin. Ultrasound guided TEA was more effective and safer than conventional TEA, and using a flat blade needle was better than conventional needles for TEA. No serious adverse events were reported from using TEA, and only a few mild side effects were observed. However, the limited number and heterogeneity of the included studies, together with the unclear methodological quality, indicate that higher-quality studies need to be conducted to determine the effectiveness and safety of TEA for cervical radiculopathy.

• The Journal of Korean Medicine
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• v.42 no.3
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• pp.165-175
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• 2021

Background: Many herbal medications have been used to treat various liver diseases. But the concerns of herbal medicine induced liver injury also existed. In this respect, we would like to report several cases with imporved elevated liver aminotransferase after treating herbal medicine including Artemisia capillaris. Case Reports: We report four patients with elevated aminotransferase levels (ATLs), which indicate hepatocellular damages. After receiving herbal medicines therapy containing Artemisia capillaris as principal component (HMA), the patients' ATLs were improved. In the first case, the patient's ATLs decreased into normal range after administration of HMA, although they have not been improved with hepatotonics for a long period. In the second case, the patient's ATLs have been elevated after taking anticoagulants. The ATLs were improved with HMA without stopping anticoagulants. In the other two cases, the patients' ATLs were also improved after taking HMA. In addition, there were no changes of previous drugs for treating the corresponding underlying diseases and no adverse events during HMA applications. Result and Conclusion: The four patients received the herbal medicine containing Artemisia capillaris as principal component and showed improvement of ATLs. These cases suggest that HMA can be considered as alternative or complementary remedies to improve various liver diseases.

• The Journal of Korean Medicine
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• v.43 no.1
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• pp.112-135
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• 2022

Objectives: The objective of this study was to summarize clinical studies conducted over the last five years that investigated the effect of acupuncture on Parkinson's disease and to propose a better process of study. Methods: Research Information Sharing Service (RISS), Korea Studies Information Service (KISS), Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, and China National Knowledge Infrastructure (CNKI) were systemically searched for clinical trials that had investigated the effect of acupuncture on the course of Parkinson's disease from May 2016 to April 2021. Results: A total of 23 studies met all the inclusion criteria. In most reports, acupuncture had significant positive effects on the course of Parkinson's disease. Furthermore, there were no serious adverse events associated with acupuncture in any of the studies. In addition to the acupuncture methods that showed effectiveness in previous studies, various types of acupuncture have been used to treat sub-symptoms of Parkinson's disease. The outcome measures were subdivided through individual symptom evaluation and mechanical analysis. Follow-up assessments were also performed to analyze the continuous effect. Conclusion: In the clinical studies conducted over the last five years, many studies investigated the various types of acupuncture used to treat Parkinson's disease and the segmentation and diversification of outcome measures focusing on individual symptoms, and a new approach for excluding placebo effects through follow-up studies has been made. Further attempts like these are needed to overcome methodological flaws in studies on the effects of acupuncture on Parkinson's disease.