• The Journal of Korean Medicine
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• v.43 no.1
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• pp.112-135
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• 2022

Objectives: The objective of this study was to summarize clinical studies conducted over the last five years that investigated the effect of acupuncture on Parkinson's disease and to propose a better process of study. Methods: Research Information Sharing Service (RISS), Korea Studies Information Service (KISS), Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, and China National Knowledge Infrastructure (CNKI) were systemically searched for clinical trials that had investigated the effect of acupuncture on the course of Parkinson's disease from May 2016 to April 2021. Results: A total of 23 studies met all the inclusion criteria. In most reports, acupuncture had significant positive effects on the course of Parkinson's disease. Furthermore, there were no serious adverse events associated with acupuncture in any of the studies. In addition to the acupuncture methods that showed effectiveness in previous studies, various types of acupuncture have been used to treat sub-symptoms of Parkinson's disease. The outcome measures were subdivided through individual symptom evaluation and mechanical analysis. Follow-up assessments were also performed to analyze the continuous effect. Conclusion: In the clinical studies conducted over the last five years, many studies investigated the various types of acupuncture used to treat Parkinson's disease and the segmentation and diversification of outcome measures focusing on individual symptoms, and a new approach for excluding placebo effects through follow-up studies has been made. Further attempts like these are needed to overcome methodological flaws in studies on the effects of acupuncture on Parkinson's disease.

• Journal of Medicine and Life Science
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• v.19 no.1
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• pp.20-25
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• 2022

This study aimed to examine the changes in the Numerical Rating Scale (NRS), Oswestry Disability Index (ODI), and Roland Morris Disability Questionnaire (RMDQ) scores before and after epidural steroid injection (ESI) in patients with lower back pain, and the correlation between the three scales in patients with reduced scores on these scales. Patients completed the NRS, ODI, and RMDQ before and after receiving ESI. A paired t-test was performed to compare the mean scores obtained before and after ESI. The correlations between the scores were estimated by calculating the difference between the baseline and follow-up scores. Of the 49 patients, 37 completed both questionnaire assessments. Among them, 26 patients (70%) presented a post-ESI decrease in scores obtained on all three scales. The NRS score decreased from 6.81±1.91 points at baseline to 3.66±2.22 points at follow-up (P<0.0001); similarly, the ODI score decreased from 41.65±14.76 to 30.38±16.16 points (P=0.0025); and the RMDQ score decreased from 11.11±5.68 to 7.64±5.74 points (P=0.011). Of the 37 patients who completed the two questionnaires, 26 had reduced NRS, ODI, and RMDQ scores. The intraclass correlation coefficients between the NRS and ODI, NRS and RMDQ, and ODI and RMDQ scores were 0.7943, 0.6615, and 0.7182, respectively. The concordance correlation coefficients between the NRS and ODI, NRS and RMDQ, and ODI and RMDQ scores were 0.6020, 0.4938, and 0.5202, respectively. Among the measurements, the correlation between the NRS and ODI scores was the highest, and a moderate correlation was found between the scores obtained using the other instruments.

• Korean Journal of Clinical Pharmacy
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• v.32 no.4
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• pp.328-335
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• 2022

Background: Case-based learning (CBL) is becoming an important approach for improving interprofessional collaboration education. Previous studies have examined learners' satisfaction with interprofessional education (IPE) in medical institutions. However, there are few studies on the implementation of university-led CBL interventions and their direct effects on learning outcomes. The aim of this study was to evaluate the effectiveness of CBL interventions on changes in the participants' perception and knowledge acquisition ability. Methods: The CBL approach consisted of team-based case-based learning, self-directed learning, and post-feedback. It was conducted as a single course for pharmacy students in their 5th year in a university setting. Changes in the participants' perceptions and self-assessments of competence levels were evaluated using survey responses. The effect of the CBL intervention on knowledge acquisition ability was directly evaluated using the exam score. Results: The majority agreed or strongly agreed that team-based case-based learning, and self-directed learning helped them to improve their knowledge and skills to a higher level and to increase the self-assessment of competency level. The average score of knowledge acquisition ability (average score of 75.0, p=0.0098) was significantly higher in the CBL intervention group than the lecture-based learning intervention group (average score of 52.0). Conclusion: The participants positively perceived that CBL intervention helped them to effectively improve their knowledge and the self-assessment of competency level. It also enhanced knowledge acquisition ability. These data, based on the survey responses, suggest that it is necessary to implement CBL interventions in a university-led single professional education.

• KIPS Transactions on Software and Data Engineering
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• v.12 no.6
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• pp.243-250
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• 2023

Chest X-ray is radiological examination for xeamining the lungs and haert, and is particularly widely used for diagnosing lung disease. Since the quality of these chest X-rays can affect the doctor's diagnosis, the process of evaluating the quality must necessarily go through. This process can involve the subjectivity of radiologists and is manual, so it takes a lot of time and csot. Therefore, in this paper, based on the chest X-ray quality assessment guidelines used in clinical settings, we propose a tool that automates the five quality assessments of artificial shadow, coverage, patient posture, inspiratory level, and permeability. The proposed tool reduces the time and cost required for quality judgment, and can be further utilized in the pre-processing process of selecting high-quality learning data for the development of a learning model for diagnosing chest lesions.

• Tuberculosis and Respiratory Diseases
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• v.86 no.2
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• pp.120-132
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• 2023

Background: To systematically review studies on inhaled corticosteroids (ICS) and lung cancer incidence in chronic airway disease patients. Methods: We conducted electronic bibliographic searches on OVID-MEDLINE, EMBASE, and the Cochrane Database before May 2020 to identify relevant studies. Detailed data on the study population, exposure, and outcome domains were reviewed. Results: Of 4,058 screened publications, 13 eligible studies in adults with chronic obstructive pulmonary disease (COPD) or asthma evaluated lung cancer incidence after ICS exposure. Pooled hazard ratio and odds ratio for developing lung cancer in ICS exposure were 0.81 (95% confidence interval, 0.64 to 1.02; I²=95.7%) from 10 studies and 1.02 (95% confidence interval 0.50 to 2.07; I²=94.7%) from three studies. Meta-regression failed to explain the substantial heterogeneity of pooled estimates. COPD and asthma were variously defined without spirometry in 11 studies. Regarding exposure assessment, three and 10 studies regarded ICS exposure as a time-dependent and fixed variable, respectively. Some studies assessed ICS use for the entire study period, whereas others assessed ICS use for 6 months to 2 years within or before study entry. Smoking was adjusted in four studies, and only four studies introduced 1 to 2 latency years in their main or subgroup analysis. Conclusion: Studies published to date on ICS and lung cancer incidence had heterogeneous study populations, exposures, and outcome assessments, limiting the generation of a pooled conclusion. The beneficial effect of ICS on lung cancer incidence has not yet been established, and understanding the heterogeneities will help future researchers to establish robust evidence on ICS and lung cancer incidence.

• Physical Therapy Rehabilitation Science
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• v.12 no.3
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• pp.207-213
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• 2023

Objective: The purpose of this study was to understand the complex anatomical structure and function of the midbrain to better understand the patient's symptoms and plan effective treatment including pharmacological and rehabilitation interventions. Design: A single case study Methods: A 17-year-old girl presented with acute onset of drowsiness, gait disturbance, mutism, and ptosis. Physical examination revealed postural instability, rigidity of all limbs, and limitations in extraocular movement. The brain MRI revealed an isolated acute infarction in the bilateral midbrain. Considering the location of the infarction, the presenting symptoms were the result of an impairment of the dopaminergic pathway in addition to lesions in the nuclei of the oculomotor nerve. Levodopa/carbidopa was prescribed. And the intensive and comprehensive rehabilitation program was done. Results: As a result of the study, through comprehensive intervention, which encompassed assessments such as the manual muscle test, Korean Modified Barthel Index score, and Trail-making test, significant enhancements in the patient's condition were observed. These findings provide evidence supporting the effectiveness of the intervention in promoting the patient's physical functioning and overall well-being. Conclusions: The results of this case highlight the significance of comprehending the intricate anatomical structure and functional aspects of the midbrain, which led us to approach appropriate pharmacological and rehabilitation interventions. Through active communication among the medical team, we were able to establish a therapeutic plan, which demonstrated that effective treatment can be achieved.

• Anxiety and mood
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• v.19 no.2
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• pp.37-47
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• 2023

This review article explores the psychological characteristics, comorbid mental disorders, and psychosocial assessments throughout the solid organ transplant journey, spanning the pre-transplant, peri-transplant, and post-transplant phases for transplant recipients. The psychological burden and anxiety in the pre-transplant phase are high for organ failure patients with complex physical difficulties who are deciding to undergo transplantation and are on the waiting list. The pre-transplant psychosocial evaluation covers various aspects, including the patient's readiness, awareness of, and commitment to transplant treatment, medical compliance, psychopathological conditions such as cognitive function and personality disorders, lifestyle factors, including substance abuse, as well as various psychosocial factors like social support. During the peri-transplant phase, mental health problems such as postoperative delirium should be carefully recognized and addressed. After transplantation, it is essential to assist patients in coping with the various stressful experiences they encounter, manage psychiatric symptoms such as depression, anxiety, and insomnia, and improve treatment adherence and quality of life during long-term care for the transplanted organ. Managing psychiatric problems in post-transplant patients requires a deep understanding of immunosuppressant medications and a keen awareness of associated risks, including adverse effects and potential drug interactions. This comprehensive review emphasizes the significance of proactive mental health care and psychosocial evaluation, highlighting the necessity of a multidisciplinary approach to enhance the quality of life and overall success of transplant patients throughout all phases of transplantation.

• Nuclear Engineering and Technology
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• v.55 no.10
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• pp.3815-3821
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• 2023

Dosimetric studies in Nuclear Medicine are very important, especially with new therapeutic methods, the number of which has increased significantly with the Theranostic approach (determining diagnostic-therapeutic pairs where similar molecules are labelled with different isotopes in order to diagnose and treat malignant diseases). Peptide receptor radionuclide therapy (PRRT) has been used successfully for many years to treat neuroendocrine tumors (NET). ⁹⁰Y-DOTATOC is one of the radiopharmaceuticals used frequently in this type of therapy. In this work, blood and urine samples from 13 patients treated with ⁹⁰Y-DOTATOC were measured by a liquid scintillation beta counter (LSC). Calibration of the beta counter for this type of measurement was done and all results are presented in the paper. The presented paper also provides a methodology for determining the measurement uncertainty for this type of measurement. Immediately after the administration of radiopharmaceuticals, the activity in the blood was different from 6.31% to 88.9% of the applied radioactivity, while 3 h after the termination of the application, the average value of radiopharmaceuticals in the blood was only 3.84%. The activity in the excreted urine depended on the time when the patients urinated after the therapy. It was measured that as much as 58% of the applied radioactivity was excreted in the first urine after the therapy in a patient who urinated 4.5 h after the completed application of the therapy. In most patients, the highest urine activity was in the first 10 h after the application, while the activities after that time were negligibly low. The described methodology of measuring and evaluating activity in blood and excreted urine can be applied to other radiopharmaceuticals used in nuclear medicine. It could be useful for researchers for dosimetric assessments in clinical application of PRRT.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.4
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• pp.275-282
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• 2023

Objectives: This study aimed to identify the psychiatric comorbidity status of adult patients diagnosed with attention-deficit hyperactivity disorder (ADHD) and determine the impact of comorbidities on neuropsychological outcomes in ADHD. Methods: The study participants were 124 adult patients with ADHD. Clinical psychiatric assessments were performed by two board-certified psychiatrists in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. All participants were assessed using the Mini-International Neuropsychiatric Interview Plus version 5.0.0 to evaluate comorbidities. After screening, neuropsychological outcomes were assessed using the Comprehensive Attention Test (CAT) and the Korean version of the Wechsler Adult Intelligence Scale, Fourth Edition (K-WAIS-IV). Results: Mood disorders (38.7%) were the most common comorbidity of ADHD, followed by anxiety (18.5%) and substance use disorders (13.7%). The ADHD with comorbidities group showed worse results on the Perceptual Organization Index and Working Memory Index sections of the K-WAIS than the ADHD-alone group (p=0.015 and p=0.024, respectively). In addition, the presence of comorbidities was associated with worse performance on simple visual commission errors in the CAT tests (p=0.024). Conclusion: These findings suggest that psychiatric comorbidities are associated with poor neuropsychological outcomes in adult patients with ADHD, highlighting the need to identify comorbidities in these patients.

• Journal of Biomedical Engineering Research
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• v.45 no.2
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• pp.95-100
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• 2024

Vitiligo is a condition characterized by the destruction or dysfunction of melanin-producing cells in the skin, resulting in a loss of skin pigmentation. Facial vitiligo, specifically affecting the face, significantly impacts patients' appearance, thereby diminishing their quality of life. Evaluating the efficacy of facial vitiligo treatment typically relies on subjective assessments, such as the Facial Vitiligo Area Scoring Index (F-VASI), which can be time-consuming and subjective due to its reliance on clinical observations like lesion shape and distribution. Various machine learning and deep learning methods have been proposed for segmenting vitiligo areas in facial images, showing promising results. However, these methods often struggle to accurately segment vitiligo lesions irregularly distributed across the face. Therefore, our study introduces a framework aimed at improving the segmentation of vitiligo lesions on the face and providing an evaluation of vitiligo lesions. Our framework for facial vitiligo segmentation and lesion evaluation consists of three main steps. Firstly, we perform face detection to minimize background areas and identify the face area of interest using high-quality ultraviolet photographs. Secondly, we extract facial area masks and vitiligo lesion masks using a semantic segmentation network-based approach with the generated dataset. Thirdly, we automatically calculate the vitiligo area relative to the facial area. We evaluated the performance of facial and vitiligo lesion segmentation using an independent test dataset that was not included in the training and validation, showing excellent results. The framework proposed in this study can serve as a useful tool for evaluating the diagnosis and treatment efficacy of vitiligo.