• 사상체질의학회지
• /
• 제34권2호
• /
• pp.48-64
• /
• 2022

Objectives The purpose of this study was to review and evaluate the clinical evidence of the efficacy and safety of treatment based on Sasang constitutional medicine (SCM) for post-stroke patients by systematic review and meta-analysis. Methods Randomized controlled trials (RCTs), published in 10 electronic databases up to December 2020, were searched. For the included studies, Cochrane's risk of bias assessment was performed to analyze the methodological quality. The strength of evidence was evaluated using the grading of recommendations assessment, development, and evaluation system based on the results of analyses. All review processes were performed by two independent researchers. Results Five RCTs were finally included. All included RCTs were conducted for one month on post-stroke patients in 60-80s, four studies on Tae-Eum patients and one study on So-Yang patients. Four types of constitution-specific herbal medicine (Chungpyesagan-tang, Cheongsimsanyak-tang, Yeoldahanso-tang, and Yangkyuksanhwa-tang) and constitution-specific acupuncture therapy were identified as interventions. More than half of the included studies were evaluated as low quality due to the high-risk of bias in selection, performance, and detection. The combination of constitution-specific herbal medicine, acupuncture, and conventional treatment was more effective in improving the patients' motor impairment, dysphagia, aphasia, and depression than conventional treatment alone. No serious adverse events by SCM treatment were reported. Conclusions SCM treatment may improve the sequelae of post-stroke patients safely in combination with conventional treatment. Since the quality of clinical evidence included in this study was low, higher quality clinical evidence obtained in well-designed clinical studies will be needed.

• Journal of Gastric Cancer
• /
• 제22권1호
• /
• pp.3-23
• /
• 2022

Countries differ in their treatment expertise and research results regarding gastric cancer; hence, treatment guidelines are diverse based on evidence and medical situations. A comprehensive and comparative review of each country's guidelines is imperative to understand the similarities and differences among countries. We reviewed and compared five gastric cancer treatment guidelines in terms of endoscopic, surgical, perioperative, and palliative systemic treatment based on evidence levels and recommendation grades, as well as the postoperative follow-up strategies for each guideline. The Korean, Chinese, and European guidelines provided evidence and grading of the recommendations. The United States guidelines suggested categories for evidence and consensus. The Japanese guidelines suggested evidence and recommendations only for systemic treatment. The Korean and Japanese guidelines described endoscopic treatment, surgery, and lymphadenectomy in detail. The Chinese, United States, and European guidelines more intensively considered perioperative chemotherapy. In particular, the indications for chemotherapy and the regimens recommended by each guideline differed slightly. Considering their medical situations, each guideline had some diversity in terms of adopting evidence, which resulted in heterogeneous recommendations. This review will help medical personnel to comprehensively understand the diversity in gastric cancer treatment guidelines for each country in terms of evidence and recommendations.

• 대한한방내과학회지
• /
• 제43권2호
• /
• pp.122-129
• /
• 2022

Objective: This study investigates the efficacy of Korean medical treatment for a patient with peripheral facial palsy caused by cerebellar artery infarction. Methods: A 45-year-old male patient with right facial palsy and left side numbness from cerebellar artery infarction was treated with herbal medicine (ligigeopoongsan), acupuncture, pharmacopuncture, and cupping therapy for 37 days. The effects were evaluated using the House-Brackmann (H-B) and Yanagihara's unweighted grading systems. Results: Following treatment, the patient's H-B grade decreased and Yanagihara score improved. Conclusion: Korean medical treatment improved peripheral facial palsy in a patient with cerebellar artery infarction.

• 대한한방내과학회지
• /
• 제43권2호
• /
• pp.130-143
• /
• 2022

Objective: This case report presents the effects of traditional Korean medical treatment for a patient with symptoms of the upper burner due to Beçhet's disease. Methods: A 42-year-old male patient was treated with traditional Korean herbal medicine (herbal formulas and patent medicines), acupuncture, and cupping therapy. Neck, ocular, and right wrist pain and xerostomia were assessed daily with a numeric rating scale (NRS) and grading assessment tool for subjective symptoms. Results: For a total of 20 days over two hospitalizations, the patient's neck pain was relieved from NRS 4 to 1, the ocular pain from NRS 5 to 1, the right wrist pain from NRS 7 to 1, and the xerostomia from grade 8 to 1. Conclusion: These results show that Beçhet's disease symptoms of the upper burner can be relieved with traditional Korean medical treatment, although additional well-designed studies are required to confirm these findings.

• 창의정보문화연구
• /
• 제7권3호
• /
• pp.177-185
• /
• 2021

미래교육에서는 학습자 주도의 교육방식과 평가방식의 변화로 교육의 패러다임이 바뀌고 있다. 또한 AI 기반의 학습 인프라와 소프트웨어 교육은 그 역할와 필요성이 점점 확대되고 있다. 이에 본 연구에서는 미래교육에서 추구하는 AI 기반의 평가를 학습자 주도 평가에 접목시켜 그 효과성을 고찰해 보고자 하였다. AI 교육 및 평가 관련 문헌 연구와 학습자 주도형의 소프트웨어 평가 방법 7단계를 인용하여 초등학교 수준에 맞는 평가요소를 2015 개정 초등 실과교육과정 내용 요소인 소프트웨어의 이해, 절차적 문제해결, 프로그래밍 요소와 구조 평가요소와 연계하여 추출하고자 하였다. 앞으로 관련 연구를 통해 소프트웨어 교육에서 AI 기반의 학습자 주도 평가 요소를 적용한 채점 시스템을 개발하여 그 효과성을 지속적으로 입증한 후 학교 현장이 소프트웨어 교육에서 AI 기반의 학습자 주도 평가를 통해 미래교육을 주체적으로 준비해 나가는 데 도움이 되고자 한다.

• Physical Therapy Rehabilitation Science
• /
• 제10권4호
• /
• pp.387-397
• /
• 2021

Objective: The purpose of this case study was to investigate selective region high-frequency diathermy at trigger points with therapeutic exercises on pain, function, balance and gait in older patients with degenerative knee osteoarthritis (DKO). Design: A case report. Methods: The patient who participated in this study was a 71-year-old woman, who had been diagnosed with moderate osteoarthritis with grade II Kellgren & Lawrence grading scale. The intervention consisted of selective region high-frequency diathermy at trigger points, with hip and knee stretching and strengthening exercises. The participant was given assessments before and after every intervention session using the Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), the Timed Up and Go test (TUG) and the 10 Meter Walk Test (10MWT). The participant performed the intervention 18 times for a total of 30 minutes each. Results: As a result of this study, the patient VAS decreased to 3 points, and the WOMAC decreased to 53 points. In addition, the TUG decreased to 3.25 s and the 10MWT decreased to 1.14 s. Conclusions: The results of this study suggest that selective region high-frequency diathermy at trigger points with therapeutic exercises may be an effective intervention to decrease pain, improve knee function, balance and gait in patients with DKO. The selective region high-frequency diathermy with therapeutic exercises may be feasible and provide potential benefits for rehabilitation of DKO.

• Clinics in Shoulder and Elbow
• /
• 제25권2호
• /
• pp.112-120
• /
• 2022

Background: The prognostic factors for patients with full-thickness rotator cuff tears (RCTs) include tear size, muscle atrophy and fatty infiltration. However, the influence of early coexisting degenerative changes on RCT outcomes is unappreciated. The purpose of this study was to calculate the impact that pre-existing partial glenohumeral cartilaginous changes have on patients undergoing arthroscopic RCT repair. Methods: A study of 54 patients undergoing arthroscopic RCT repair was undertaken. The presence of co-existing patches of glenohumeral degenerative cartilaginous changes and RCT size was recorded at surgery. Pre- and postoperative outcomes were assessed using traditional (Oxford Shoulder Score [OSS], 5-level EuroQol-5D [EQ-5D-5L] questionnaire and EuroQol visual analog scale [EQ-VAS]) and patient-centric re-formatted prisms. Outcomes were assessed as an entire dataset, and sub-group analysis was performed according to the grade of co-existing arthritis and tear size. Results: Significant improvements (p<0.05) in clinical outcomes were recognized when assessed using either the traditional or reformatted prisms (average % improvements in OSS, EQ-5D-5L and EQ-VAS were 47%, 33% and 43%, respectively; average improvements in pain, function, and psychological well-being were 48%, 33% and, 29%, respectively). Positive gain was noted in all sub-groups of arthritic grading and tear size. Conclusions: Good clinical outcomes can be achieved following RCT repair even in the presence of local partial degenerative cartilage changes and advancing tear size. These benefits are patient-centered but require RCT repairability.

• Archives of Plastic Surgery
• /
• 제49권5호
• /
• pp.633-641
• /
• 2022

Introduction In chronic facial palsy, synkinetic muscle overactivity and shortening causes muscle stiffness resulting in reduced movement and functional activity. This article studies the role of multimodal therapy in improving outcomes. Methods Seventy-five facial palsy patients completed facial rehabilitation before being successfully discharged by the facial therapy team. The cohort was divided into four subgroups depending on the time of initial attendance post-onset. The requirement for facial therapy, chemodenervation, or surgery was assessed with East Grinstead Grade of Stiffness (EGGS). Outcomes were measured using the Facial Grading Scale (FGS), Facial Disability Index, House-Brackmann scores, and the Facial Clinimetric Evaluation scale. Results FGS composite scores significantly improved posttherapy (mean-standard deviation, 60.13 ± 23.24 vs. 79.9 ± 13.01; confidence interval, -24.51 to -14.66, p < 0.0001). Analysis of FGS subsets showed that synkinesis also reduced significantly (p < 0.0001). Increasingly, late clinical presentations were associated with patients requiring longer durations of chemodenervation treatment (p < 0.01), more chemodenervation episodes (p < 0.01), increased doses of botulinum toxin (p < 0.001), and having higher EGGS score (p < 0.001). Conclusions This study shows that multimodal facial rehabilitation in the management of facial palsy is effective, even in patients with chronically neglected synkinesis. In terms of the latency periods between facial palsy onset and treatment initiation, patients presenting later than 2 years were still responsive to multimodal treatment albeit to a lesser extent, which we postulate is due to increasing muscle contracture within their facial muscles.

• Clinics in Shoulder and Elbow
• /
• 제25권2호
• /
• pp.101-105
• /
• 2022

Background: Rotator cuff tears cause pathologies of the long head of the biceps tendon (LHBT). One of the surgical treatments for such a tear is LHBT tenodesis to the humerus. This study aims to compare simultaneous rotator cuff repair and LHBT tenodesis with or without detachment of the proximal end of the LHBT (PELHBT) from its site of adhesion to the glenoid. Methods: This retrospective study involved patients affected by LHBT pathology with rotator cuff tear. The patients were divided into two groups, with or without PELHBT detachment from the glenoid. Therapeutic outcomes were investigated by evaluation of patient satisfaction, pain based on visual analog scale, shoulder function based on Constant score and simple shoulder test, and biceps muscle strength based on the manual muscle testing grading system before surgery, at 6 months, and at the final visit after surgery. Results: Groups 1 and 2 comprised 23 and 26 patients, respectively, who showed no significant differences in demographic characteristics (p>0.05). Shoulder function, biceps muscle strength, pain, and satisfaction rate improved over time (p<0.05) but were not significantly different between the two groups (p>0.05). No post-surgical complication was found in either group. Conclusions: There was no difference in final outcomes of tenodesis with or without detachment of the PELHBT from the supraglenoid tubercle. Such tendon detachment is not necessary.

• Archives of Plastic Surgery
• /
• 제49권4호
• /
• pp.488-493
• /
• 2022

Background Currently, the BREAST-Q can effectively measure patient's satisfaction on the quality of life from the patient's perspective in relation to different type of breast reconstruction. However, evaluation of patient satisfaction and cosmetic outcomes in breast reconstruction may have potential to led bias. Methods To maximize the benefits of using BREAST-Q to evaluate clinical outcome, we performed comparative study focused on the correlation between postoperative BREAST-Q and cosmetic outcomes assessed by medical professionals. For the current analysis, we used three postoperative BREAST-Q scales (satisfaction with breast, psychosocial well-being, and sexual well-being). The Ten-Point Scale by Visser et al was applied to provide reproducible grading of the postoperative cosmetic outcomes of the breast. The system includes six subscales that measured overall aesthetic outcome, volume, shape, symmetry, scarring, and nipple-areolar complex. The photographic assessments were made by five medical professionals who were shown photographs on a computer screen in a random order. Obtained data were stored in Excel and evaluated by Spearman's correlations using SPSS Statistics. Results We enrolled 92 women in this study, 10 did not respond to all scales of postoperative BREAST-Q, the remaining 82 women had undergone breast reconstruction. The correlation between BREAST-Q score and aesthetic score measured by Ten-Point Scale for the three BREAST-Q scales all show positive values in Spearman's correlation coefficient. Conclusion A significant correlation without any bias observed was found between the patient's satisfaction measured by BREAST-Q after breast reconstruction and the medical expert's aesthetic evaluation.