• The Journal of Pediatrics of Korean Medicine
• /
• 제30권1호
• /
• pp.32-39
• /
• 2016

Objectives To evaluate the effectiveness of allergic rhinitis treatment, and to set the ground in clinical studies, adequate outcome measures must be established. Thus, this study was designed to develop useful criteria based on those that have been suggested, and those that we are using today. Methods To assess outcome measures used in allergic rhinitis in Korean medicine, related articles found in Korea Traditional Knowledge Portal from 2000-2015 were evaluated. Then pattern identification and outcome measures were reviewed in each study. Results Among 27 studies, we have found 24 studies used subjective symptoms as outcome measures, 9 studies used quality of life, and most of allergic rhinitis were caused by Spleen-Gi deficiency. Conclusions It is necessary to develop outcome measures that directly reflect pattern identifications in Korean medicine, and those measures need to be further evaluated for their applicability, validity and sensitivity.

• Journal of Korean Foot and Ankle Society
• /
• 제11권1호
• /
• pp.72-78
• /
• 2007

Purpose: This study is to analysis the outcome of patient with surgically treated Maisonneuve fracture and find out the factors that might influence the outcome. Material and methods: 20 patients who had surgical treatment due to Maisonneuve fracture between February, 2001 to March, 2005 were studied. The patients were followed for at least 1 year and average follow up period was 25 months. The average age was 41 years, 16 were male and 4 were female. Mechanism of injury according to Rouge-Hansen classification was supination-external rotation. In all cases, percutaneous screw fixation was applied proximal to tibiofibular syndesmosis. The screws were removed after 8 weeks under local anesthesis. Clinical, functional and radiographic results were evaluated. Results: 17 cases (85%) showed satisfying clinical and radiographic results. The mean functional score according to Ankle Scoring System was 91 (83 to 95). Complication occurred in 1 case with underlying systemic disease and 2 cases with initial ankle joint dislocation. Conclusion: Surgical treatment of Maisonneuve fracture showed relatively satisfying result. However, initial injury state and accompanying disease seem to have great effect on the result.

• The Journal of Pediatrics of Korean Medicine
• /
• 제15권2호
• /
• pp.177-188
• /
• 2001

Background : Atopic Dermatitis is thought to be a common and chronic relapsing inflammatory skin disease that probably results from allergic reaction. Because it make some serious problems in children, it is needed to treat and at least subside symptoms. Objective : The aim of this study was to evaluate the efficacy of GamiYeoldahansotang(加味熱多寒少湯) for treating Atopic Dermatitis and survey the general characteristics in children with Atopic Dermatitis. Method : Atopic Dermatitis with typical clinical symptoms were included in this study. Forty two patients were treated with hot water extract of GamiYeoldahansotang(加味熱多寒少湯) for four weeks. Clinical evaluation were made by Jacob T scoring system before and after treatment. Total Serum IgE, Eosinophil count were also conducted. Results : Reduction in body surface area was not observed. But significant reductions of severity scores before and after adminstration of GamiYeoldahansotang(加味熱多寒少湯) were observed in all of three groups: mind, moderate, severe. specially severe intensity group was very statistically significant.(p<0.05) Conclusion : We speculate that GamiYeoldahansotang(加味熱多寒少湯) has some therapeutic effects in mitigating the symptoms of Atopic Dermatitis.

• Korean Journal of Child Studies
• /
• 제13권2호
• /
• pp.203-216
• /
• 1992

The purpose of this study was to investigate the utility of the Luria-Nebraska Battery-Children's Revision (LNNB-CR) in the clinical situation in Korea: LNNB-CR was applied clinically in order to examine how well it differentiates brain damaged children from normals. Subjects were 30 children with the average age of 10 years. Among them 15 were diagnosed as the 'brain damaged' group, and the remaining 15 were normal. All subjects of the two groups were tested on all items in accordance with LNNB-CR manual. Data were analyzed by percentage, correlation coefficient, and t-test. The results were (1) the degree of consistency between testers averaged 97.2％ which confirmed the stability of the scoring system. (2) Split-half reliability was ranged from .75 on the Tactile Scale (C3) to .95 on the Memory Scale (C10). Thus, consistency of items within the scales appeared high. (3) Internal consistency reliability ranged from .74 on the Visual Scale (C4) to .98 on the Reading Scale (C9). Thus, the homogenity of items within the scales appeared high. (4) In the diagnostic discriminative power test between the two groups, both individual scales and total scores showed significant differences at the level of p<.001. (5) The discriminative power test between two groups on all items showed significant differences at the level of p<.05 or better in 126(85％) out of 149 items. These results are supportive of the diagnostic utility of the application of LNNB-CR to the clinical situation in Korea. However, extensive additional research is needed in order to prove its worth.

• Journal of Obesity & Metabolic Syndrome
• /
• 제27권4호
• /
• pp.213-222
• /
• 2018

Bariatric surgery has evolved from a surgical measure for treating morbid obesity to an epochal remedy for treating metabolic syndrome as a whole, which is represented by type 2 diabetes mellitus. Numerous clinical trials have advocated bariatric or metabolic surgery over nonsurgical interventions because of markedly superior metabolic outcomes in morbidly obese patients who satisfy traditional criteria for bariatric surgery (body mass index [BMI] >$35kg/m^2$) and in less obese or simply overweight patients. Nevertheless, not all diabetes patients achieve the most desirable outcomes; i.e., diabetes remission after metabolic surgery. Thus, candidates for metabolic surgery should be carefully selected based on comprehensive preoperative assessments of the risk-benefit ratio. Predictors for diabetes remission after metabolic surgery may be classified into two groups based on mechanism of action. The first is indices for preserved pancreatic beta-cell function, including younger age, shorter duration of diabetes, and higher C-peptide level. The second is the potential for an insulin resistance reduction, including higher baseline BMI and visceral fat area. Several prediction models for diabetes remission have been suggested by merging these two to guide the joint decision-making process between clinicians and patients. Three such models, DiaRem, ABCD, and individualized metabolic surgery scores, provide an intuitive scoring system and have been validated in an independent external cohort and can be utilized in routine clinical practice. These prediction models need further validation in various ethnicities to ensure universal applicability.

• Journal of The Korean Society of Clinical Toxicology
• /
• 제6권1호
• /
• pp.32-36
• /
• 2008

Purpose: The major complication of acute organophosphate (OP) poisoning is respiratory failure as a result of cholinergic toxicity. Many clinicians find it difficult to predict the optimal time to initiate mechanical ventilation (MV) weaning, and as a result have tended to provide a prolonged ventilator support period. The purpose of this study is to determine any clinical predictors based on patients characteristics and laboratory findings to assist in the optimal timing of mechanical ventilator weaning. Methods: We reviewed medical and intensive care records of 44 patients with acute OP poisoning who required mechanical ventilation admitted to medical intensive care unit between July 1998 and June 2007. Patient information regarding the poisoning, clinical data and demographic features, APACHE II score, laboratory data, and serial cholinesterase (chE) levels were collected. Base on the time period of MV, the patients were divided into two groups: early group (wean time < 7 days, n = 28) and delayed group (${\geq}$ 7 days, n = 16). Patients were assessed for any clinical characteristics and predictors associated with the MV weaning period. Results: During the study period, 44 patients were enrolled in this study. We obtained the sensitivity and specificity values of predictors in the late weaning group. APACHE II score and a reciprocal convert of hypoxic index but specificity (83.8%) is only APACHE II score. Also, the chE concentration (rho = -0.517, p = 0.026) and APACHE II score (rho = 0.827, p < 0.001) correlated with a longer mechanical ventilation duration. Conclusion: In patients with acute OP poisoning who required mechanical ventilation, the APACHE II scoring system on a point scale of less than 17 and decrements in cholinesterase levels on 1-3 days were good predictors of delayed MV weaning.

• Journal of Korean Foot and Ankle Society
• /
• 제10권2호
• /
• pp.163-167
• /
• 2006

Purpose: To evaluate the results of extracorporeal shock wave therapy (ESWT) for patients with chronic proximal plantar fascitis. Materials and Methods: Between April 2005 and April 2006, 35 cases (24 patients) who were followed more than 6 months were evaluated. By $EvoTron^{(R)}$, 2 sessions of ESWT (Group 1: 1200 and Group 2: 1500 shock waves / session of $0.12\;mJ/mm^2$) were performed at 2 weeks interval. The mean age was 40.0 (range, 15-59) years. 13 patients were male and 11 patients were female. Visual analogue scale (VAS) on daily activity and a 100-point scoring system including 70 points for pain and 30 points for function were used. The clinical outcomes were rated as follows: excellent, no pain on daily activity; good, less than 50% of previous VAS; fair, 50-75% of previous VAS; or poor, more than 75% of previous VAS. Excellent and good were graded as satisfactory results. We compare clinical results between groups and evaluate the relationships between clinical results and duration of symptom, fascial thickening and previous steroid injection were evaluated. Results: Overall satisfactory rate were 71.4%. There was no significant difference of clinical results between groups. And there were no significant difference between clinical results and duration of symtom, preoperative fascial thickening and previous steroid injection. Conclusions: ESWT for recalcitrant chronic proximal plantar fascitis is useful treatment method with high patient satisfaction and pain relief, but more long-term study must be needed.

• Korean Journal of Radiology
• /
• 제24권3호
• /
• pp.190-203
• /
• 2023

Objective: We aimed to assess and validate the radiologic and clinical factors that were associated with recurrence and survival after curative surgery for heterogeneous targetoid primary liver malignancies in patients with chronic liver disease and to develop scoring systems for risk stratification. Materials and Methods: This multicenter retrospective study included 197 consecutive patients with chronic liver disease who had a single targetoid primary liver malignancy (142 hepatocellular carcinomas, 37 cholangiocarcinomas, 17 combined hepatocellular carcinoma-cholangiocarcinomas, and one neuroendocrine carcinoma) identified on preoperative gadoxetic acid-enhanced MRI and subsequently surgically removed between 2010 and 2017. Of these, 120 patients constituted the development cohort, and 77 patients from separate institution served as an external validation cohort. Factors associated with recurrence-free survival (RFS) and overall survival (OS) were identified using a Cox proportional hazards analysis, and risk scores were developed. The discriminatory power of the risk scores in the external validation cohort was evaluated using the Harrell C-index. The Kaplan-Meier curves were used to estimate RFS and OS for the different risk-score groups. Results: In RFS model 1, which eliminated features exclusively accessible on the hepatobiliary phase (HBP), tumor size of 2-5 cm or > 5 cm, and thin-rim arterial phase hyperenhancement (APHE) were included. In RFS model 2, tumors with a size of > 5 cm, tumor in vein (TIV), and HBP hypointense nodules without APHE were included. The OS model included a tumor size of > 5 cm, thin-rim APHE, TIV, and tumor vascular involvement other than TIV. The risk scores of the models showed good discriminatory performance in the external validation set (C-index, 0.62-0.76). The scoring system categorized the patients into three risk groups: favorable, intermediate, and poor, each with a distinct survival outcome (all log-rank p < 0.05). Conclusion: Risk scores based on rim arterial enhancement pattern, tumor size, HBP findings, and radiologic vascular invasion status may help predict postoperative RFS and OS in patients with targetoid primary liver malignancies.

• Clinical and Experimental Pediatrics
• /
• 제59권3호
• /
• pp.126-131
• /
• 2016

Purpose: To evaluate the diagnostic value of the Vesikari Scoring System (VSS) as an early predictor of pathogens in children with acute gastroenteritis (AG). Methods: In this retrospective study, the VSS score, absolute neutrophil count (ANC), and C-reactive protein (CRP) levels were analyzed in 107 hospitalized children with AG, aged 6 months to 17 years. Patients were divided into nonspecific, viral, and bacterial groups according to the pathogens detected using a multiplex polymerase chain reaction (PCR) test. Results: Patients in the bacterial group had significantly higher CRP values and VSS scores compared to those in the viral group and significantly higher VSS scores compared to those in the nonspecific group (P<0.05). Patients in the viral group had significantly higher VSS scores than those in the nonspecific group (P<0.05). Logistic regression analysis revealed that VSS was the most effective diagnostic tool for predicting the type of pathogen (P<0.05). The area under the receiver operating characteristics curve of VSS was significantly greater than that for ANC and CRP (P<0.05). At a cutoff point of 10 in the VSS, an acceptable diagnostic accuracy could be achieved for distinguishing between bacterial and viral pathogens in AG. Conclusion: VSS can be considered a useful and reliable infectious marker for pediatric gastroenteritis. VSS may be a good early predictor of the type of pathogen, enabling development of a treatment plan before results from a stool culture or PCR test are available.

• Hip & pelvis
• /
• 제30권4호
• /
• pp.260-268
• /
• 2018

Purpose: This study was performed to assess the clinical and radiological outcomes following one-stage hip reconstruction, consisting of open reduction femoral shortening and pelvic osteotomy, for neglected developmental dislocation of the hip (DDH). Materials and Methods: This is a retrospective analysis of 77 hips in 65 patients (46 females and 19 males; 12 had bilateral dislocations), operated at a Ghurki Trust Teaching Hospital in Pakistan between 2013 and 2015. The average age at surgery was $11.02{\pm}3.43$ years. According to the Tonnis classification, there were 10, 14, 22, and 31 patients in grades 1, 2, 3, and 4, respectively. The pelvic procedure utilized in this study was triple osteotomy (47 hips) followed by double and Salter osteotomy (18 and 12 hips, respectively). Postoperative evaluations were conducted using the modified MacKay's scoring system (functional outcomes) and Severin's scoring method (radiological assessment). Results: Postoperatively, there were 38 (49.4%), 19 (24.7%), 14 (18.2%), and 6 (7.8%) hips in Severin grade I, II, III and IV, respectively. According to the modified McKay criteria, there were 22 hips (28.6%) in excellent condition, 44 (57.1%) in good condition, 9 (11.7%) in fair condition and 2 (2.6%) in poor condition. Both patients with poor outcomes had an unstable, painful hip with evidence of avascular necrosis of the femoral head. Conclusion: Based on the results presented here, we recommend the single stage procedure of open reduction, femoral shortening and pelvic osteotomy for treatment of DDH in older children with good to excellent functional and radiological outcomes.