Forte, Antonio Jorge;Boczar, Daniel;Huayllani, Maria Tereza;Moran, Steven;Okanlami, Oluwaferanmi O.;Ninkovic, Milomir;Broer, Peter N.
Archives of Plastic Surgery
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제48권5호
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pp.528-533
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2021
Bladder acontractility affects several thousand patients in the United States, but the available therapies are limited. Latissimus dorsi detrusor myoplasty (LDDM) is a therapeutic option that allows patients with bladder acontractility to void voluntarily. Our goal was to conduct a systematic review of the literature to determine whether LDDM is a better option than clean intermittent catheterization (CIC) (standard treatment) in patients with bladder acontractility. On January 17, 2020, we conducted a systematic review of the PubMed/MEDLINE, Cochrane Clinical Answers, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials.gov databases, without time frame limitations, to identify articles on the use of LDDM for bladder acontractility. Of 75 potential articles, 4 fulfilled the eligibility criteria. The use of LDDM to treat patients with bladder acontractility was reported in four case series by the same group in Europe. Fifty-eight patients were included, and no comparison groups were included. The most common cause of bladder acontractility was spinal cord injury (n=36). The mean (±standard deviation) operative time was 536 (±22) minutes, postoperative length of hospital stay ranged from 10 to 13 days, and follow-up ranged from 9 to 68 months. Most patients had complete response, were able to void voluntarily, and had post-void residual volume less than 100 mL. Although promising outcomes have been obtained, evidence is still weak regarding whether LDDM is better than CIC to avoid impairment of the urinary tract among patients with bladder acontractility. Further prospective studies with control groups are necessary.
Objectives: This study is to analyze Acupuncture Methods(鍼法) using Five Transport Points(五輸穴) and to consider the direction of development. Methods: This study focuses on Acupuncture Methods(鍼法) using Five Transport Points(五輸穴) that Five Phase Theory(五行學說) has been applied as a compound and it is designated Five Phase-Five Transport Points-Acupuncture Method(FPT Acupuncture Method, 五行五輸穴鍼法). Principles, Acupuncture Points(經穴), standards of diagnosis and treatment subjects of FPT Acupuncture Methods used in practices of Korean Medicine (韓醫學) were analyzed through updated literature. Next, the theoretical issues of FPT Acupuncture Methods regarding the composition of selecting exclusively on Five Transport Points(五輸穴) and targeted treatment subjects were investigated. Based upon the investigation, the future direction of development was studied. Results & Conclusions: Firstly, pattern identification and treatment of FPT Acupuncture Methods targeted mostly on Viscera and Bowels(臟腑). However, some showed the tendency to Five Phases Reductionism(五行 還元主義) which attempts to apply Five Phase Theory(五行學說) to symptoms that were not related to Viscera and Bowels(臟腑). Secondly, Five Transport Points(五輸穴) are theoretically related to 'Viscera and Bowels in Concept of Visceral Manifestation(臟象臟腑)'. Thirdly, when the cause of the symptoms exceeds the main therapeutic range of FPT Acupuncture Methods, it is effective to add Acupuncture Points(經穴) excluding Five Transport Points(五輸穴). And also, it is efficient to use Acupuncture Methods(鍼法) that is not based on principles of Five Phase Theory(五行學說). For the accomplishment, further researches on the approaches to apply basic Korean Medical principles such as Three Yin and Three Yang(三陰三陽) into Acupuncture Methods(鍼法) and Acupuncture Points(經穴) are necessary.
Study Design: Olfactory ensheathing cells (OECs) from rat olfactory mucosa were cultured, characterized, and transplanted into a rat model of spinal cord injury (SCI). Purpose: To evaluate different doses of OECs in a rat model of SCI. Overview of Literature: SCI causes permanent functional deficit because the central nervous system lacks the ability to perform spontaneous repair. Cell therapy strategies are being explored globally. The clinical use of human embryonic stem cell is hampered by ethical controversies. Alternatively, OECs are a promising cell source for neurotransplantation. This study aimed to evaluate the efficacy of different doses of allogenic OEC transplantation in a rat model of SCI. Methods: OECs were cultured from the olfactory mucosa of Albino Wistar rats; these cells were characterized using immunohistochemistry and flow cytometry. Rats were divided into five groups (n=6 rats each). In each group, different dosage ($2{\times}10^5$, $5{\times}10^5$, $10{\times}10^5$, and >$10{\times}10^5$) of cultured cells were transplanted into experimentally injured spinal cords of rat models. However, in the SCI group, only DMEM (Dulbecco's modified Eagle's medium) was injected. Rats were followed up upto 8 weeks post-transplantation. The outcome of transplantation was assessed using the Basso, Beattie, Bresnahan (BBB) scale; motor-evoked potential studies; and histological examination. Results: Cultured cells expressed 41% of p75NTR, a marker for OEC, and 35% of anti-fibronectin, a marker for olfactory nerve fibroblast. These cells also expressed $S100{\beta}$ and glial fibrillary acid protein of approximately 75% and 83%, respectively. All the transplanted groups showed promising BBB scores for hind-limb motor recovery compared with the SCI group (p<0.05). A motor-evoked potential study showed increased amplitude in all the treated groups compared with the SCI. Green fluorescent protein-labeled cells survived in the injured cord, suggesting their role in the transplantation-mediated repair. Transplantation of $5{\times}10^5$ cells showed the best motor outcomes among all the doses. Conclusions: OECs demonstrated a therapeutic effect in rat models with the potential for future clinical applications.
Objectives : The purpose of this study is to review clinical studies about the effect of chuna manual therapy (CMT) for peripheral facial paralysis in children. Methods : In this review, we searched 11 electronic databases (Pubmed, Cochrane Library, EMBASE, CINAHL, CAJ, Oasis, NDSL, KISS, RISS, KISTI, Dbpia); We concluded our literature search in April 23, 2019. We included only randomized controlled trials (RCTs) of testing CMT for peripheral facial paralysis in children. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. The meta-analysis was performed by synthesizing outcome data of total efficacy rate (TER). Results : After screening papers, a total of 6 RCTs were selected and analyzed. In the 6 RCTs, patients(n=15-60 per study) were randomized into groups for treatment and control. Specifically, the treatment group received CMT, while the control group was concurrently given usual care, such as acupuncture and medicine. The meta-analysis showed that the treatment group receiving CMT alone showed significant improvement in TER, compared to the control group receiving acupuncture therapy alone(P<0.05). And the treatment group receiving CMT combined with usual care showed positive results, in terms of TER, compared to the control group receiving usual care, but was not statistically significant(P>0.05). Conclusions : Our analysis suggests that CMT has therapeutic effects for peripheral facial paralysis in children. However, to confirm this result, further investigation accompanied by high quality studies is required.
Objectives : This study was conducted to investigate current research trends in Chuna manual therapy for the treatment of anxiety disorders in China. Methods : Using China Academic Journal and Pubmed, we performed a literature search of studies that were published from 2010 onwards. In total, 15 published studies were included in our analysis. Results : Of the 15 analyzed studies, nine were randomized controlled trials, two were non-randomized controlled trials, and four were case reports. Of the total patients, 80% were treated daily and received ${\leq}30$ treatments in total (excluding one study). In most studies(11 out of 15, 73.33%), the total effective rate of treatment was used to measure the outcome, with the Hamilton Anxiety Rating Scale being used most frequently. The case report demonstrated a therapeutic effect > 90%. In the control study, except for the two studies that reported significant improvement in the follow-up period, all of the measures were significantly improved (P<0.05) after treatment compared with before treatment. The An(按) and Rou(?) methods were the most frequently used. The Chuna method is categorized into four types: 1) It is performed around shoulders, neck, and face; 2) performed around abdomen, back, and neck; 3) performed on the whole body; 4) performed at the simply-stimulated acupoints. The most commonly used acupoint was Taiyang (Ex-HN 5), and the most frequently used acupoints were predominantly distributed in the head, face, and neck. Conclusions : This study demonstrated that Chuna manual therapy has significant effects when used as a treatment for anxiety disorder, warranting further investigation.
Objective: The aim of the present study was to develop a valid and reliable scale that measures the healthy life styles among young adults. Design: A methodological study design was employed to develop and validate the Healthy Lifestyle Screening Tool (HLST). Methods: The validity and reliability of the HLST were established in accordance with DeVellis' 8 steps guideline for tool development. The question items were generated based on literature reviews and interviews, which were then classified into 12 categories. The HLST was administered to 272 students attending a Korean university. The reliability was tested using Cronbach's alpha. The validity of the scale was examined with the mean inter-item correlations (MIIC) and factor analysis, and was also examined for content validity by experts. Results: The reliability of the HLST was found to be acceptable, as indicated by a Cronbach's alpha of 0.71. In the validity test, items with less than 80% "agreement" ratings on the content validity index by experts were revised. The MIIC values were greater than 0.25. A factor analysis of 36 items extracted 9 factors (i.e., four items per factor), which together explained 50.4% of the variance. The HLST consists of 36 items that measure 9 factors based on a 4-point Likert rating scale, with 4 items per factor, as follows: sunlight, water, air, rest, exercise, nutrition, temperance, trust, and general physical condition. High scores on the HLST are indicative of a healthy lifestyle (HL). Conclusions: The HLST is a valid and reliable scale that can be used to measure HL among young adults. Identification of HL by using the HLST can provide guidance to integrated therapeutic approaches along with conventional physical therapy.
Objectives: The purpose of this study is to analyze the domestic study trends of pharmacopuncture therapy on obstetrics and gynecological diseases in Korean literature, through reviewing the clinical and experimental studies. Methods: We searched for clinical and experimental studies using pharmacopuncture therapy on obstetrics and gynecological diseases, published from January 2000 to May 2019, through 5 Korean databases. The study design, target disease, type of pharmacopuncture, method of intervention, and study results were analyzed. Results: 36 experimental studies and 15 clinical studies were finally included according to inclusion and exclusion criteria. In experimental studies, there were 12 studies about postmenopausal osteoporosis, 9 studies about obesity, 4 studies about endometriosis, 3 studies about hemostatic effects and analgesic anticoagulative effects, 2 studies about ovarian function, and analgesic antiphlogistic anticoagulative effects, and 1 study about menopausal symptoms. In clinical studies, there were 3 studies about obesity, postpartum disorders, dysmenorrhea, and women's urologic disease, and 1 study about menopausal symptoms, atypical squamous cells of undetermined significance (ASCUS) and breast cancer. Various types of pharmacopuncture have been proved to have a therapeutic effect in each of those obstetrics and gynecological diseases. Conclusions: This study indicates that pharmacopuncture therapy could be a good treatment for obstetrics and gynecological diseases. However, more well-designed and high-quality clinical researches are needed in further studies, to prove the effectiveness and safety of pharmacopuncture therapy.
In drug discovery or preclinical stages of development, potency parameters such as $IC_{50}$, $K_i$, or $K_d$ in vitro have been routinely used to predict the parameters of efficacious exposure (AUC, $C_{min}$, etc.) in humans. However, to our knowledge, the fundamental assumption that the potency in vitro is correlated with the efficacious concentration in vivo in humans has not been investigated extensively. Thus, the present review examined this assumption by comparing a wide range of published pharmacokinetic (PK) and potency data. If the drug potency in vitro and its in vivo effectiveness in humans are well correlated, the steady-state average unbound concentrations in humans [$C_{u_-ss.avg}=f_u{\cdot}F{\cdot}Dose/(CL{\cdot}{\tau})=f_u{\cdot}AUCss/{\tau}$] after treatment with approved dosage regimens should be higher than, or at least comparable to, the potency parameters assessed in vitro. We reviewed the ratios of $C_{u_-ss.avg}$/potency in vitro for a total of 54 drug entities (13 major therapeutic classes) using the dosage, PK, and in vitro potency reported in the published literature. For 54 drugs, the $C_{u_-ss.avg}$/in vitro potency ratios were < 1 for 38 (69%) and < 0.1 for 22 (34%) drugs. When the ratios were plotted against $f_u$ (unbound fraction), "ratio < 1" was predominant for drugs with high protein binding (90% of drugs with $f_u{\leq}5%$; i.e., 28 of 31 drugs). Thus, predicting the in vivo efficacious unbound concentrations in humans using only in vitro potency data and $f_u$ should be avoided, especially for molecules with high protein binding.
Objectives: Many fields have changed since covid-19, psychotherapy being no exception. With the pandemic associated increase in untact treatment, interest in virtual reality exposure therapy has also increased. The aim of study was to analyze recent literature using virtual reality therapy for the treatment of anxiety disorders. Methods: We searched five databases from dates between October 1 to November 1, 2020. We selected articles related to the treatment of anxiety disorders using virtual reality therapy and analyzed the trend of that, not thesis but domestic articles. Results: There were 6 RCT studies and 3 were case reports where, based on the DSM-4, the participants presented with anxiety disorders including 2 with presentation anxiety, 1 heterosexual anxiety, 1 test anxiety, 1 social anxiety, 1 dental anxiety, 2 Acrophobia, and 1 social phobia. Treatment sessions varied from 1 session to 18 sessions, but 5 studies conducted 4 sessions, and all studies attempted virtual reality exposure for 30-minute time periods. 8 studies used HMD as the VR device and 1 study did not report a device. Conclusions: Anxiety disorders treated using virtual reality included speech anxiety and acrophobia. Median treatment session number was 4 and sessions were less than 30 minutes. The most common VR device used was an HMD. VR psychotherapy showed limitations relating to patient experience including cyber sickness and a lack of immersion. In addition, most of the studies were conducted with patients who visited hospitals utilizing Western medical practices. Currently, virtual reality therapy (VRT) intervention in oriental medicine is lacking. The lack of research in this area suggests analyzing data from VR psychotherapy in oriental medicine could provide novel and useful information.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제47권4호
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pp.291-314
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2021
Squamous cell carcinoma (SCC) of the retromolar trigone (RMT) is a rare but potentially fatal disease that carries a poor prognosis due to its unique anatomic position. RMT SCCs tend to spread to vital nearby structures, including the tonsillar pillar, masticatory muscles, and underlying mandibular bone, even in their early stages, and aggressive treatment is often warranted. This systematic review appraises and qualitatively analyzes all available literature regarding the survival outcomes and prognosis of RMT SCC. Four databases were searched to identify all eligible articles published since January 1980. Of the 1,248 studies, a total of 15 studies representing 4,838 cases met the inclusion criteria. The evaluated patients had a high rate of advanced tumor stage (T3 or T4: 61.4%), lymph node metastasis (38.8%), and mandibular bone invasion (24%) at the time of diagnosis. Aggressive surgical treatments such as lip-splitting (92%), segmental mandibulectomy (61.1%), radical neck dissection (44.1%), and reconstruction using free flaps (49.5%) was undertaken for 92% of the pooled patient population. The mean rates for local, regional, and systemic recurrence were 23.40%, 8.40%, and 8.50%, respectively. The mean 5-year overall survival rate was 38.90%. Osteonecrosis was noted in 11.6% of the 328 patients who received radiotherapy. In conclusion, RMT SCC is generally associated with high recurrence, low survival, and high postoperative complication rates. Early diagnosis and aggressive treatment are thus warranted. However, significant methodological problems hamper current knowledge. Future studies of this topic that use randomized or cohort designs are thus needed.
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