• Title/Summary/Keyword: Clinical Effectiveness

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Case Report on Three Patients with Cervical Myofascial Pain Syndrome Showing Improvement with Ultrasound-Guided Pharmacopuncture: Proposal of the 'SLS Triangle' Treatment Protocol (경추근막통증증후군에 대한 초음파 유도하 약침 치료 3례 증례보고)

  • Hongmin Chu;Seongjun Park;Taegwang Nam;Kwangho Kim;Junhui Kwon;Hyeon Joon Hong;Juhwan Song;Sanghyuk Kwon;Jaehyo Kim;Hyein Jeong;Kyeong Han Kim;Robin Kwon
    • Korean Journal of Acupuncture
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    • v.41 no.3
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    • pp.101-109
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    • 2024
  • Objectives : Cervical myofascial pain syndrome (C-MPS), a key aspect of Visual Display Terminals (VDT) Syndrome, leads to acute and chronic pain due to muscle shortening, potentially causing headaches and movement disorders. This study examines the effectiveness of Pharmacoacupuncture at the intersection of the Splenius Capitis (SC), Levator Scapulae (LS), and Serratus Posterior Superior(SPS) muscles under ultrasound guidance, known as the "SLS triangle" in treating C-MPS. Methods : Three patients (aged 30 to 37) with acute C-MPS presented at two Korean medicine clinics with severe neck pain and restricted cervical rotation. The evaluation of symptoms before treatment, immediately after treatment, and one day after treatment was conducted using the cervical rotation Range of motion (ROM) and the Numeric Rating Scale (NRS) for cervical pain. Treatments included Acupuncture, Cupping therapy, Chuna manipulation, Physical Therapy, and Pharmacopuncture (Jaha-geo extract, 2cc at the SLS triangle). Results : All three patients showed significant improvement post-treatment. Immediately after treatment, Patient 1's NRS improved from 7 to 2, Patient 2's NRS improved from 4 to 1, and Patient 3's NRS improved from 6 to 2. Directly after the procedure, there were no significant adverse reactions except for one patient experiencing temporary dizziness. When the patients were followed up by phone 24 hours later, no adverse reactions were reported. Conclusions : This study demonstrates that ultrasound-guided pharmacopuncture can significantly reduce pain and improve cervical rotation in patients with cervical myofascial pain syndrome. The findings suggest this non-invasive treatment is both safe and effective, warranting further research through larger-scale clinical trials to validate its efficacy and establish standardized protocols.

Predicting Helicobacter pylori infection from endoscopic features

  • Jun-young Seo;Ji Yong Ahn;Seonok Kim;Hee Kyong Na;Jeong Hoon Lee;Kee Wook Jung;Do Hoon Kim;Kee Don Choi;Ho June Song;Gin Hyug Lee;Hwoon-Yong Jung
    • The Korean journal of internal medicine
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    • v.39 no.3
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    • pp.439-447
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    • 2024
  • Background: Helicobacter pylori infection, prevalent in more than half of the global population, is associated with various gastrointestinal diseases, including peptic ulcers and gastric cancer. The effectiveness of early diagnosis and treatment in preventing gastric cancer highlights the need for improved diagnostic methods. This study aimed to develop a simple scoring system based on endoscopic findings to predict H. pylori infection. Methods: A retrospective analysis was conducted on 1,007 patients who underwent upper gastrointestinal endoscopy at Asan Medical Center from January 2019 to December 2021. Exclusion criteria included prior H. pylori treatment, gastric surgery, or gastric malignancies. Diagnostic techniques included rapid urease and 13C-urea breath tests, H. pylori culture, and assessment of endoscopic features following the Kyoto gastritis classification. A new scoring system based on endoscopic findings including regular arrangement of collecting venules (RAC), nodularity, and diffuse or spotty redness was developed for predicting H. pylori infection, utilizing logistic regression analysis in the development set. Results: The scoring system demonstrated high predictive accuracy for H. pylori infection in the validation set. Scores of 2 and 3 were associated with 96% and 99% infection risk, respectively. Additionally, there was a higher prevalence of diffuse redness and sticky mucus in cases where the initial H. pylori eradication treatment failed. Conclusions: Our scoring system showed potential for improving diagnostic accuracy in H. pylori infection. H. pylori testing should be considered upon spotty redness, diffuse redness, nodularity, and RAC absence on endoscopic findings as determined by the predictive scoring system.

A Systematic Review and Meta-Analysis of the Effects of Action Learning-Based Education Program on Nursing Students (간호대학생의 액션러닝 기반 교육프로그램 효과에 대한 체계적 문헌고찰 및 메타분석)

  • Mi-Hyeon Park;Yong-Joo Cho
    • Journal of Practical Engineering Education
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    • v.16 no.4
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    • pp.587-598
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    • 2024
  • This study aimed to evaluate the effectiveness of an action learning-based educational program for domestic nursing students. A systematic review and meta-analysis were conducted following PRISMA guidelines. Limited to the period from January 2013 to December 2023, a search conducted across the electronic databases DBpia, RISS, KCI, KISS, and SCIENCE ON identified a total of 779 documents. From these, 13 documents that met the established selection criteria were ultimately included. Thirteen documents meeting the selection criteria were identified, and quality evaluation was independently performed by two researchers using ROBINS-I. The effect size of the action learning-based education program was analyzed using the 'Meta package' in the R program. The effect size for problem-solving was ESr=.68 (95% CI=.30 to 1.06). For communication skills, the effect size was ESr=.39 (95% CI=-.08 to .85), and for critical thinking, the effect size was ESr=.26 (95% CI=.02 to .50). Action learning-based educational programs have been shown to be an effective method for enhancing problem-solving skills and critical thinking among nursing students. Therefore, there is a need for the active implementation of action learning techniques to further develop nursing students' clinical practice capabilities within nursing education.

Economic evaluation of a weekly administration of a sustained-release injection of recombinant human growth hormone for the treatment of children with growth hormone deficiency (소아 성장호르몬결핍증 치료에 사용되는 성장호르몬 서방형 주사제의 경제성 평가)

  • Kang, Hye-Young;Kim, Duk Hee;Yang, Sei-Won;Kim, Yoon-Nam;Kim, Miseon
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1249-1259
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    • 2009
  • Purpose:From a societal perspective, we evaluated the cost-effectiveness of a novel sustained-release injection of recombinant human growth hormone (GH) administered on a weekly basis compared with that of the present daily GH injection for the treatment of children with GH deficiency. Methods:Health-related utility for GH therapy was measured based on the visual analogue scale. During July 2008, caregivers of 149 children receiving GH therapy form 2 study sites participated in a web-based questionnaire survey. The survey required the caregivers to rate their current subjective utility with daily GH injections or expected utility of weekly GH injections. Because there was no difference in the costs of the daily and weekly therapies, for the purposes of this study, only drug acquisition costs were considered. Results:Switching from daily to weekly injection of GH increased the utility from 0.584 to 0.784 and incurred an extra cost of 4,060,811 Korean won (KW) per year. The incremental cost-utility ratio (ICUR) for a base case was 20,305,055 KW per quality-adjusted life year (QALY) gained. Scenario analyses showed that the ICUR ranged from 15,751,198 to 25,489,929 KW per QALY. Conclusion:The ICUR for a base case and worst case scenario analyses ranged from 0.85 to 1.37-times per capita gross domestic product of Korea, which is considered to be within the generally accepted willingness-to-pay threshold. Thus, it is concluded that switching from daily to weekly injection of GH would be cost-effective.

Arthroscopic Repair of Full Thickness Tear of The Supraspinatus; Evaluation of the Clinical Outcome and the Postoperative Rotator Cuff Integrity (견관절 극상건 전층 파열의 관절경적 복원술; 임상적 결과 및 술후 회전근개 상태의 평가)

  • Noh, Kyu-Cheol;Chung, Kook-Jin;Kim, Sung-Woo;Yoo, Jung-Han
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.1
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    • pp.50-57
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    • 2006
  • Purpose: The purpose of this study was to evaluate the tendon healing of arthroscopic repair in full-thickness supraspinatus tears. We evaluate the effectiveness of the arthroscopic repair of full-thickness supraspinatus tears by assessing functional improvement. Materials and Methods: Thirty consecutive full-thickness supraspinatus tears were repaired arthroscopically in 19 patients with a one row of anchor and 11 patients with two rows of anchors. Patients ranged in age from 51 to 79 years (average 63 years). Average follow-up was 16 month (range, 12 to 28 months). To evaluate the effectiveness of the arthroscopic repair of full-thickness supraspinatus tears by assessing functional improvement, we calculate the Constant, ASES, UCLA scores. The 30 patients had either an MR Arthrogram (25 cases) or an MRI (5 cases), performed between 5 months and 20 months (mean 10 months) after surgery. Results: The cuff was healed in 21/30 cases (70%) and partially torn in 3 cases (10%) after the arthroscopic repair of full-thickness supraspinatus tear. Although the supraspinatus tendon was totally torn to the tuberosity in 6 cases(20%) after the arthroscopic repair, the size of the tear was smaller than the initial in 5 cases. The Constant score improved from an average of $55.7{\pm}7.1$ points preoperatively to $77.7{\pm}9.7$ points at the last follow-up (p<0.001), and the average ASES score improved from $39.2{\pm}7.4\;to\;72.4{\pm}12.6$ (p<0.001), and the average UCLA score improved from $17.9{\pm}2.2\;to\;26.8{\pm}5.0$ (p<0.001). Strength of elevation was significantly better $(7.1kgs{\pm}2.4)$ in the shoulders with a healed tendon that in those with an total or partial re-tear tendon $(4.5kgs{\pm}1.0)$ (p<0.05). Factors adversely affecting tendon healing were increasing age, Only 41.7% of the repairs completely healed in patients over 65 years (p<0.05). Conclusion: Arthroscopic repair of isolated full-thickness tear of the supraspinatus leads to completely healing in 70% of the cases. Total or partial re-tear of the repaired rotator cuff is associated with a decreased strength. Older patients had significantly lower healing rates.

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A Trial of Aerosolized Colistin for the Treatment of Nosocomial Pneumonia due to Multidrug-resistant Acinetobacter baumannii (다제내성 A. baumannii에 의한 병원획득폐렴에서 Colistin 분무치료의 시도)

  • Kim, Changhwan;Kim, Dong-Gyu;Kang, Hye-Ryun;Choi, Jeong-Hee;Lee, Chang Youl;Hwang, Yong Il;Shin, Tae Rim;Park, Sang Myeon;Park, Yong Bum;Lee, Jae Young;Jang, Seung Hun;Kim, Cheol Hong;Mo, Eun Kyung;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck;Choi, Young-Jin;Lee, Jae Woong
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.2
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    • pp.102-108
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    • 2008
  • Background: Recently, multidrug-resistant (MDR) A. baumannii has been implicated for a significant proportion of nosocominal pneumonia in many intensive care units (ICUs), and its acquisition may increase mortality and the length of stay in the ICU. Aerosolized colistin has been successfully used in patients with cystic fibrosis, but there is a lack of data regarding the use of aerosolized colistin in patients with nosocomial pneumonia. Methods: We conducted the present study to assess the effectiveness of aerosolized colistin for the treatment of MDR A. baumannii nosocomial pneumonia. We retrospectively reviewed the medical records of 10 patients who had been hospitalized in the medical ICU and had received aerosolized colistin as a therapy for MDR A. baumannii pneumonia. Results: The mean duration of aerosolized colistin therapy was $12.7{\pm}2.4$ days. Nine (90%) of 10 patients showed a favorable response to the therapy. Follow-up cultures were available for all patients, and the responsible pathogen was completely eradicated. One patient suffered from bronchospasm, which resolved after treatment with nebulized salbutamol. Conclusion: Our results corroborate previous reports that aerosolized colistin may be an effective and safe choice for the treatment of nosocomial pneumonia caused by MDR A. baumannii. Larger prospective controlled clinical studies are warranted to validate further the effectiveness and safety of aerosolized colistin therapy.

Effects of the Massage Therapy on Weight, Stress Hormone and Mother - Infant Interaction (마사지요법이 저체중아의 성장, 생리적 변화 및 모.영아 상호작용에 미치는 효과)

  • Kim, Mi-Ye;Kim, Sun-Hee
    • Korean Parent-Child Health Journal
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    • v.3 no.1
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    • pp.1-14
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    • 2000
  • The Low Birth Weight infant birth rate in this country is a little more than 15 percent and is being increased. The survival rate of Low Birth Weight infant is over 90 percent and recently the rate runs is getting. However, because of the high risk of Low Birth Weight infant for handicap in growth, a preventive nursing intervention program for Low Birth Weight infant and their mother is considered to be necessary. Touch and massage, thus sensory stimulation has been considered to be important ensuring a normal growth of Low Birth Weight infant During the past decades sensory stimulation program has been used for premature and Low Birth Weight infants. Recently a study on the sensory stimulation for Low Birth Weight infants has bee n done in this country. Mother and infant relationship has a great influence on child's development. Especially, mother and infant interaction during one year after birth plays important role in child's social. affective and cognitive developments. But in the study of Low Birth Weight infants, the mother and infant interaction has been rare yet. However, there was no study effectiveness of the sensory stimulation on mother and infant interaction. In this respect, this study based on the importance of the nursing intervention, is intended to measure the effectiveness of the massage therapy in the aspects of weight, daily feeding amount, cortisolurine stress hormone and mother and infant interactions. This study has been conducted on the nonequivalent control group pretestposttest design in quasi experimental basis and Low Birth Weight infants from NICU of two Medical University Hospitals located in Taegu Metropolitan were selected in experimental group of 21 infants and control group of 20 infants. Data has been collected from May 1, 1999 to September 5, 2000. For the experimental group Field's sensory stimulation(tactile and kinesthetic stimulation) was applied 2 times a day for 10 days(10:00 - 11:00 hours in the morning and 19:00 - 20:00 in the afternoon) by nurse and mother. The electronic indicator scale (Cas Co. Korea) was used to measure infant's body weight. To determine urine cortisol concentration level under stress, rad immuno assay method was used. And to determine mother and infant interactions during feeding, tools developed by Kim Mi-Ye (1999) were used. Collected data were analyzed with SAS program using x-test, t-test, paired t-test and repeated measures ANOVA. Findings were as follows : 1. For the daily mean weight gain, the experimental group showed little higher than the control group, even though, there was no Statistically significant differences between two groups. 2. For the amount of daily mean feeding, the experimental group showed little higher than the control group, while there was no Statistically significant differences between two groups. 3. The level of wine cortisol concentration was increased in both groups, while no Statistical significance was shown between the two groups. 4. Mothers in experimental group were more likely to have higher mean scores in mother and infant interaction during feeding than mothers in the control group. Statistical significance was shown between the two groups(t= 5.78, P=.001). In conclusion, the massage therapy in this study showed with regard to even though through there was no statistically significance in the weight gain and urine stress hormone concentration. there was Statistical significantly higher in the mother and infant interaction during feeding. Based on the result of this study, it is considered that the massage therapy should be applied clinical practice and home to help a developmental growth and interaction of Low Birth Weight infants and mothers during the period of recovery.

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The Effectiveness of Intravenous Immunoglobulin for Clinically Suspected Neonatal Sepsis (임상적으로 의심되는 신생아 패혈증에서 정맥용 면역 글로불린의 치료 효과)

  • Na, Hyun Jung;Kim, Ji Young;Lee, Gyeong Hoon;Lee, Jun Hwa;Choi, Eun Jin;Kim, Jin Kyung;Chung, Hai Lee;Kim, Woo Taek
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1187-1192
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    • 2005
  • Purpose : The purpose of this study is to determine the effectiveness of intravenous immunoglobuin (IVIG) administration in fullterm neonates having clinically suspected neonatal sepsis. Methods : Forty full-term neonates admitted to the neonatal intensive care unit with clinically suspected neonatal sepsis, who had at least two positive diagnostic criteria were enrolled. Twenty neonates were enrolled into the IVIG arm and 20 in the placebo arm. Neonates with a gestational age of less than 36 weeks and those with any major congenital malformation were excluded. The neonates were randomized to receive 1 g/kg of IVIG or equivalent amount of normal saline. The treatments including antibiotics and supportive care were administered. Results : The neonates in the therapy and placebo groups were comparable in terms of birth weight, gestational age, sex distribution, duration of antibiotics therapy and admission, elevation of serum IgG level, mortality rate, change of CBC, and serum level of acute phase reactants etc. Conclusion : Serum IgG values increased significantly 5 days after administration of IVIG in the IVIG-treated group and decreased significantly 5 days after administration of normal saline in the placebo group. However, there was no significant difference in the duration of antibiotics therapy and admission, or of mortality between the IVIG-treated and placebo groups. No adverse reactions to the IVIG infusions were noted during the study. Our preliminary observations suggest that the administration of 1 g/kg IVIG to neonates had some effect on augmentation of humural immune status in neonates with clinically suspected sepsis. But further study is needed to verify the benefit of IVIG infusion to neonatal sepsis.

The effectiveness of biochemical indexes for evaluating the nutrition states of children (소아에서 영양평가로서 생화학적 지표의 유용성)

  • Kim, Jae Kwang;Jin, Hyun Seong;Han, Myung Ki;Kim, Bong Seong;Cha, Choong Hwan;Park, Kie Young
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.167-175
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    • 2009
  • Purpose : This study has been conducted to analyze whether the biochemical nutrition indexes might be useful and effective for evaluating the nutrition states of children. Methods : We evaluated 269 children, aged 3-9 years old, who had visited Gangneung Asan Hospital for elective surgery from January 2006 to December 2007, and examined their anthropometric and preoperative laboratory data with retrospective analysis. The children were classified into underweight, normal weight, overweight, and obese groups according to body mass index (BMI). The biochemical nutrition indexes (total lymphocyte count (TLC), hemoglobin, hematocrit, serum albumin, cholesterol, et al) of each group were then analyzed statistically. Results : None of the groups showed statistically significant differences in TLC. Serum albumin decreased significantly in the underweight group. Red blood cell (RBC) count, hemoglobin, hematocrit, and serum total cholesterol in the obese group were higher than in the normal weight group. None of the groups showed statistically significant increase in mean corpuscular volume or mean corpuscular hemoglobin, and it seems that the increase of hemoglobin and RBC count in the overweight and obese groups is due to the enhancement of erythropoiesis rather than iron metabolism. However, in females, almost all nutrition indexes except albumin were statistically significantly poor. Conclusion : Serum albumin, total cholesterol, RBC count, hemoglobin, and hematocrit were useful as nutrition indexes. However, except for albumin, these indexes were significantly poor for females. More control studies are needed to confirm the effectiveness of biochemical indexes for evaluating the nutritional state of children.

Effectiveness of the Respiratory Gating System for Stereotectic Radiosurgery of Lung Cancer (폐암 환자의 정위적 방사선 수술 시 Respiratory Gating System의 유용성에 대한 연구)

  • Song Heung-Kwon;Kwon Kyung-Tae;Park Cheol-Su;Yang Oh-Nam;Kim Min-Su;Kim Jeong-Man
    • The Journal of Korean Society for Radiation Therapy
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    • v.17 no.2
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    • pp.125-131
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    • 2005
  • Purpose : For stereotactic radiosurgery (SRS) of a tumor in the region whose movement due to respiration is significant, like Lung lower lobe, the gated therapy, which delivers radiation dose to the selected respiratory phases when tumor motion is small, was performed using the Respiratory gating system and its clinical effectiveness was evaluated. Materials and Methods : For two SRS patients with a tumor in Lung lower lobe, a marker block (infrared reflector) was attached on the abdomen. While patient' respiratory cycle was monitored with Real-time Position Management (RPM, Varian, USA), 4D CT was performed (10 phases per a cycle). Phases in which tumor motion did not change rapidly were decided as treatment phases. The treatment volume was contoured on the CT images for selected treatment phases using maximum intensity projection (MIP) method. In order to verify setup reproducibility and positional variation, 4D CT was repeated. Results : Gross tumor volume (GTV) showed maximum movement in superior-inferior direction. For patient #1, motion of GTV was reduced to 2.6 mm in treatment phases ($30{\sim}60%$), while that was 9.4 mm in full phases ($0{\sim}90%$) and for patient #2, it was reduced to 2.3 mm in treatment phases ($30{\sim}70%$), while it was 11.7 mm in full phases ($0{\sim}90%$). When comparing two sets of CT images, setup errors in all the directions were within 3 mm. Conclusion : Since tumor motion was reduced less than 5 mm, the Respiratory gating system for SRS of Lung lower lobe is useful.

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