• Journal of Acupuncture Research
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• v.27 no.2
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• pp.115-121
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• 2010

Objectives : Based on a national sample survey, we present an analysis of the current situation in the use of moxibustion therapeutics by qualified medical practitioners in Korea. Methods : The survey population of 11,737 hospitals is stratified by administrative regions, and 331 of them are randomly selected from the list of hospitals. The same number of Korean medical doctors is interviewed under the computer-assisted telephone interviewing(CATI) system. The bound on the error of estimation is ${\pm}\;5.0%$ point. Results : Of the 331 Korean medical doctors surveyed, 69% have used moxibustion therapy for remedial treatment. About half of those doctors have employed the therapy for their patients over 30%. The average number of acupuncture points per treatment using the therapy mostly ranges 1 between 5. The percent of practitioners, who have the number of average minutes less than 20 in treatment, is 74%. The number of practitioners who primarily use modified moxibustion is 4 times as many as that of those using traditional moxibustion. Conclusions : Considering the survey results, if the laser heater, alternative to conventional moxibustion, which not only gives high thermal effect but also reduces both the users inconvenience and side effects, are developed, it may benefit more patients as well as Korean medical doctors.

• Journal of Korean Neurosurgical Society
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• v.46 no.3
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• pp.221-225
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• 2009

Objective : Surgical treatment of posterior inferior cerebellar artery (PICA) aneurysms is challenging due to limited surgical accessibility. Endovascular approach has a benefit of avoiding direct injury to the brainstem or lower cranial nerves. Therefore, it has recently been considered an alternative or primary modality for PICA aneurysms. We retrospectively assessed outcomes following detachable coil embolization of saccular PICA aneurysms. Methods : From February 1997 to December 2007, we performed endovascular procedures to treat 15 patients with 15 PICA aneurysms. Fourteen patients with 14 PICA aneurysms morphology of which was saccular were reviewed retrospectively. Twelve patients had ruptured aneurysms. The aneurysms arose from the PICA origin site (n=12), the PICA lateral medullary segment (n=1), or the PICA tonsilomedullary segment (n=1). Results : Complete aneurysm occlusion was achieved in 10 patients, residual neck in 3, and residual sac in one. Radiological follow-up was performed in 7 patients with mean duration of 34.7 months (range, 1-97 months) and showed stable or complete occlusion in 6 patients. There were no rebleeding or retreatment after endovascular treatment. Thromboembolism was the only procedure-related complication (n=4 ; 28.6%). Asymptomatic PICA infarction occurred in two patients and symptomatic PICA infarction in two elderly patients with poor clinical grade. Of these procedural PICA infarction cases, 1 symptomatic PICA infarction patient developed ventriculitis and septic shock leading to death. The clinical outcome was good in 10 patients (71.4%). Conclusions : In the present study, detachable coil embolization has shown as an efficient modality for PICA saccular aneurysms challenging indications of microsurgery. However, thromboembolic complications should be considered, especially in poor clinical elderly patients with ruptured aneurysms.

• Communications for Statistical Applications and Methods
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• v.24 no.6
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• pp.561-581
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• 2017

Bayesian statistics can play a key role in the design and analysis of clinical trials and this has been demonstrated for medical device trials. By 1995 Bayesian statistics had been well developed and the revolution in computing powers and Markov chain Monte Carlo development made calculation of posterior distributions within computational reach. The Food and Drug Administration (FDA) initiative of Bayesian statistics in medical device clinical trials, which began almost 20 years ago, is reviewed in detail along with some of the key decisions that were made along the way. Both Bayesian hierarchical modeling using data from previous studies and Bayesian adaptive designs, usually with a non-informative prior, are discussed. The leveraging of prior study data has been accomplished through Bayesian hierarchical modeling. An enormous advantage of Bayesian adaptive designs is achieved when it is accompanied by modeling of the primary endpoint to produce the predictive posterior distribution. Simulations are crucial to providing the operating characteristics of the Bayesian design, especially for a complex adaptive design. The 2010 FDA Bayesian guidance for medical device trials addressed both approaches as well as exchangeability, Type I error, and sample size. Treatment response adaptive randomization using the famous extracorporeal membrane oxygenation example is discussed. An interesting real example of a Bayesian analysis using a failed trial with an interesting subgroup as prior information is presented. The implications of the likelihood principle are considered. A recent exciting area using Bayesian hierarchical modeling has been the pediatric extrapolation using adult data in clinical trials. Historical control information from previous trials is an underused area that lends itself easily to Bayesian methods. The future including recent trends, decision theoretic trials, Bayesian benefit-risk, virtual patients, and the appalling lack of penetration of Bayesian clinical trials in the medical literature are discussed.

• Journal of the Korean Society for Precision Engineering
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• v.29 no.2
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• pp.222-228
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• 2012

Haptics and virtual reality are rapidly growing technologies in medical fields. Physicians and nurses can benefit from medical simulation via training and acquire surgical and clinical techniques. In this paper, the research on needle insertion force of biological tissue for haptic based intravenous injection simulator was carried out. We built the setup for needle insertion (intravenous injection) experiments and performed the experiments on live pigs. The force responses against needle insertion were measured using the experimental setup. In addition, the modeling of needle insertion force was carried out with the experimental results and numerical models via nonlinear least-squares method. The results presented in this paper indicate that the developed models can be applied not only to estimate the force feedback during intravenous injection procedure but also to improve the overall training quality of the medical simulator.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.266-272
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• 2001

Objectives : Chemotherapy remains part of the treatment triad that includes surgery and radiotherapy for the management of glioblastomas, but disappointing results of chemotherapy have raised the suggestion that chemotherapy should perhaps be abandoned. In order to determine the chemotherapy effect given in addition to radiotherapy, we performed a randomized clinical study of irradiation alone and combination of irradiation with chemotherapy in the treatment of glioblastomas. Methods : From 1991 to 1999, 204 consecutive patients suffering from supratentorial glioblastomas were treated in our hospital. We compared the survival rates/times of these patients according to the treatment modalities[group I-67 patients treated by surgery with radiotherapy and adjuvant chemotherapy(ACNU, paclitaxel, tamoxifen, and others) ; group II-106 by surgery with radiotherapy ; and group III-31 by surgery only]. Results : The overall median survival time was 12 months, with overall survival rates at 1 and 2 year of 46.7% and 16.6%, respectively. On univariate analysis, median survival and 1- and 2-year survival rates were statistically improved by the use of chemotherapy ; group I-15 months, 75.7%, and 25.9%, group II-11 months, 39.3%, and 15.4%, and group III-3 months, 9.7%, and 6.5%, respectively(p=0.0001). But, on multivariate analysis considering compounding variables, survival was independently associated only with radiotherapy(p=0.0112). Conclusion : These results suggest that the addition of chemotherapy to radiotherapy does not affect the overall survival in glioblastomas. Mainly long-survivor glioblastoma patients might benefit by adjuvant chemotherapy, which probably means patients with initial favorable prognostic factors(young age, minimal residual tumors, good performance status). It is necessary to continue to search for an effective chemotherapy regimen to prolong survival of patients with glioblastomas.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.3
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• pp.203-210
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• 2021

We performed a systematic review and meta-analysis to evaluate whether intralipid administration improved the outcomes of in vitro fertilization. Online databases (PubMed, Cochrane Library, Medline, and Embase) were searched until March 2020. Only randomized controlled trials (RCTs) that assessed the role of intralipid administration during in vitro fertilization were considered. We analyzed the rates of clinical pregnancy and live birth as primary outcomes. Secondary outcomes included the rates of chemical pregnancy, ongoing pregnancy, and missed abortion. We reviewed and assessed the eligibility of 180 studies. Five RCTs including 840 patients (3 RCTs: women with repeated implantation failure, 1 RCT: women with recurrent spontaneous abortion, 1 RCT: women who had experienced implantation failure more than once) met the selection criteria. When compared with the control group, intralipid administration significantly improved the clinical pregnancy rate (risk ratio [RR], 1.48; 95% confidence interval [CI], 1.23-1.79), ongoing pregnancy rate (RR, 1.82; 95% CI, 1.31-2.53), and live birth rate (RR, 1.85; 95% CI, 1.44-2.38). However, intralipid administration had no beneficial effect on the miscarriage rate (RR, 0.75; 95% CI, 0.48-1.17). A funnel plot analysis revealed no publication bias. Our findings suggest that intralipid administration may benefit women undergoing in vitro fertilization, especially those who have experienced repeated implantation failure or recurrent spontaneous abortion. However, larger, well-designed studies are needed to confirm these findings.

• Journal of dental hygiene science
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• v.19 no.1
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• pp.23-30
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• 2019

Background: The health of the economically active population contributes to increased corporate productivity by reducing the productivity loss caused by disease and increasing job efficiency, which in turn is a national benefit. Since the economically active population is a concept encompassing workers and a source of economic development for a country, that population's health should be treated with importance not only from a personal standpoint but also at a national level. Methods: In this study, data of 11,007 adults aged 20 years and older who participate in economic activities were analyzed in the five-year Korea Health Panel Study from 2010 to 2014 including the number of dental visits and dental medical expenses. Results: Factors related to "gender," "education level," "age," "duty category," "income level," "employment type," "national health insurance," and "chronic disease status" of the economically active population are affected in relation to the number of visits and dental medical expenses. The number of dental visits increased with higher education levels (p<0.001), and the number of visits to the dentist increased with older age (p <0.001). Dental medical expenses were 91,806 Korean won (KRW) more for "white-collar workers" than for "blue-collar workers" (p<0.03), and 127,674 KRW more for "regular workers" than for "atypical workers" (p<0.02). Conclusion: When it is necessary to improve policies to enhance the efficiency of the distribution of health and medical resources in the overall balance of the dental health sector, we should try to identify various factors of oral health disorder due to income inequality among the classes according to the country's employment type in order to find ways to reduce the health gap among the social classes.

• Clinical and Experimental Otorhinolaryngology
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• v.11 no.4
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• pp.267-274
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• 2018

Objectives. Two main digital signal processing technologies inside the modern hearing aid to provide the best conditions for hearing aid users are directionality (DIR) and digital noise reduction (DNR) algorithms. There are various possible settings for these algorithms. The present study evaluates the effects of various DIR and DNR conditions (both separately and in combination) on listening comfort among hearing aid users. Methods. In 18 participants who received hearing aid fitting services from the Rehabilitation School of Shahid Beheshti University of Medical Sciences regularly, we applied acceptable noise level (ANL) as our subjective measure of listening comfort. We evaluated both of these under six different hearing aid conditions: omnidirectional-baseline, omnidirectional-broadband DNR, omnidirectional-multichannel DNR, directional, directional-broadband DNR, and directional-multichannel DNR. Results. The ANL results ranged from -3 dB to 14 dB in all conditions. The results show, among all conditions, both the omnidirectional-baseline condition and the omnidirectional-broadband DNR condition are the worst conditions for listening in noise. The DIR always reduces the amount of noise that patients received during testing. The DNR algorithm does not improve listening in noise significantly when compared with the DIR algorithms. Although both DNR and DIR algorithms yielded a lower ANL, the DIR algorithm was more effective than the DNR. Conclusion. The DIR and DNR technologies provide listening comfort in the presence of noise. Thus, user benefit depends on how the digital signal processing settings inside the hearing aid are adjusted.

• Journal of Gastric Cancer
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• v.20 no.4
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• pp.376-384
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• 2020

Purpose: The role of prophylactic abdominal drainage in total gastrectomy is not well-established. This study aimed to evaluate the efficacy of abdominal drainage in the prevention and management of major intra-abdominal complications after total gastrectomy for gastric carcinoma. Materials and Methods: We retrospectively reviewed the data of 499 patients who underwent total gastrectomy for gastric carcinoma in a high-volume institution. The patients were divided into drainage and non-drainage groups and compared for the development and management of major intra-abdominal complications, including anastomotic leak, abdominal bleeding, abdominal infection, and pancreatic fistulas. Results: The drainage group included 388 patients and the non-drainage group included 111 patients. The 2 groups showed no significant differences in clinicopathological characteristics or operative procedures, except for more frequent D2 lymphadenectomies in the drainage group. After surgery, the overall morbidity (drainage group vs. non-drainage group: 24.7% vs. 28.8%, P=0.385) and incidence of major intra-abdominal complications (6.4% vs. 6.3%, P=0.959) did not significantly differ between the two groups. The non-drainage group showed no significant increase in the incidence rate of major intra-abdominal complications in the subgroups divided by age, sex, comorbidity, operative approach, body mass index, extent of lymphadenectomy, and pathological stage. Abdominal drainage had no significant impact on early diagnosis, secondary intervention or reoperation, or recovery from major intra-abdominal complications. Conclusions: Prophylactic abdominal drainage showed little demonstrable benefit in the prevention and management of major intra-abdominal complications of total gastrectomy for gastric carcinoma.

• Clinics in Shoulder and Elbow
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• v.24 no.4
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• pp.215-223
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• 2021

Background: The objective of this study was to compare the efficacy of platelet-rich plasma (PRP) injection with an institution-based physical therapy (PT) program for adhesive capsulitis (AC) of the shoulder in patients with diabetes mellitus (DM). Methods: A total of seventy diabetic patients with AC of the shoulder for <6 months were assigned to two groups: PRP group and PT group. In the PRP group, 35 patients were administered a single shot of PRP (4 mL) into the glenohumeral joint. In the PT group, 35 patients were given institution-based PT that included 10 30-minute sessions of planned PT over a 2-week period. After the interventions, all patients were prospectively followed for 12 weeks. Intensity of shoulder pain, function, and range of motion were assessed at baseline and then at 3, 6, and 12 weeks. Results: Thirty-three patients in the PRP group and 32 in the PT group completed the 12-week study. At 12 weeks, patients who received PRP injections showed greater improvement in shoulder pain (p<0.001) than those recruited to the PT group. In the range of motion and shoulder function activities, patients in the PRP group showed significant improvement compared with the institution-based PT group (p<0.001). No significant complications were reported from any groups. Conclusions: In a diabetic population, PRP injections significantly improved shoulder pain and function compared with an institution-based PT program for shoulder AC. Additionally, it is a safe and well-tolerated method for AC management for diabetic patients.