• Korean Journal of Radiology
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• 제22권3호
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• pp.405-414
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• 2021

Objective: To compare two clinically available MR volumetry software, NeuroQuant^® (NQ) and Inbrain^® (IB), and examine the inter-method reliabilities and differences between them. Materials and Methods: This study included 172 subjects (age range, 55-88 years; mean age, 71.2 years), comprising 45 normal healthy subjects, 85 patients with mild cognitive impairment, and 42 patients with Alzheimer's disease. Magnetic resonance imaging scans were analyzed with IB and NQ. Mean differences were compared with the paired t test. Inter-method reliability was evaluated with Pearson's correlation coefficients and intraclass correlation coefficients (ICCs). Effect sizes were also obtained to document the standardized mean differences. Results: The paired t test showed significant volume differences in most regions except for the amygdala between the two methods. Nevertheless, inter-method measurements between IB and NQ showed good to excellent reliability (0.72 < r < 0.96, 0.83 < ICC < 0.98) except for the pallidum, which showed poor reliability (left: r = 0.03, ICC = 0.06; right: r = -0.05, ICC = -0.09). For the measurements of effect size, volume differences were large in most regions (0.05 < r < 6.15). The effect size was the largest in the pallidum and smallest in the cerebellum. Conclusion: Comparisons between IB and NQ showed significantly different volume measurements with large effect sizes. However, they showed good to excellent inter-method reliability in volumetric measurements for all brain regions, with the exception of the pallidum. Clinicians using these commercial software should take into consideration that different volume measurements could be obtained depending on the software used.

• 대한한방내과학회지
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• 제45권1호
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• pp.1-10
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• 2024

Objectives: This study investigated the pattern identification (PI) and clinical index of Parkinson's disease (PD) for personalized diagnosis and treatment. Methods: This prospective observational multi-center study recruited 100 patients diagnosed with PD from two Korean medicine hospitals. To cluster new subtypes of PD, items on a PI questionnaire (heat and cold, deficiency and excess, visceral PI) were evaluated along with pulse and tongue analysis. Gait analysis was performed and blood and feces molecular signature changes were assessed to explore biomarkers for new subtypes. In addition, unified PD rating scale II and III scores and the European quality of life 5-dimension questionnaire were assessed. Results: The clinical index obtained in this study analyzed the frequency statistics and hierarchical clustering analysis to classify new subtypes based on PI. Moreover, the biomarkers and current status of herbal medicine treatment were analyzed using the new subtypes. The results provide comprehensive data to investigate new subtypes and subtype-based biomarkers for the personalized diagnosis and treatment of PD patients. Ethical approval was obtained from the medical ethics committees of the two Korean medicine hospitals. All amendments to the research protocol were submitted and approved. Conclusions: An objective and standardized diagnostic tool is needed for the personalized treatment of PD by traditional Korean medicine. Therefore, we developed a clinical index as the basis for the PI clinical evaluation of PD. Trial Registration: This trial is registered with the Clinical Research Information Service (CRIS) (KCT0008677)

• Clinics in Shoulder and Elbow
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• 제26권3호
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• pp.267-275
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• 2023

Background: Physical therapy (PT) plays an important role in the recovery of function following anatomic total shoulder arthroplasty (aTSA). While several PT protocols have been published for these patients, there is no standardized protocol for aTSA rehabilitation. This lack of standardization may lead to confusion between patients and physicians, possibly resulting in suboptimal outcomes. This study examines how PT protocols provided by academic orthopedic surgery programs vary regarding therapeutic goals and activities following aTSA. Methods: PT protocols for aTSA available online from the Accreditation Council for Graduate Medical Education accredited orthopedic surgery programs were included for review. Each protocol was analyzed to evaluate it for differences in recommendation of length of immobilization, range of motion (ROM) goals, start time for and progression of therapeutic exercises, and timing for return to functional activity. Results: Of 175 accredited programs, 25 (14.2%) had protocols publicly available, programs (92%) recommended sling immobilization outside of therapy for an average of 4.4±2.0 weeks. Most protocols gave recommendations on starting active forward flexion (24 protocols, range 1-7 weeks), external rotation (22 protocols, range 1-7 weeks), and internal rotation (18 protocols, range 4-7 weeks). Full passive ROM was recommended at 10.8±5.7 weeks, and active ROM was 13.3±3.9 weeks, on average. ROM goals were inconsistent among protocols, with significant variations in recommended ROM and resistance exercise start times. Only 13 protocols (52%) gave recommendations on resuming recreational activities (mean, 17.4±4.4 weeks). Conclusions: Publicly available PT protocols for aTSA rehabilitation are highly variable. Level of evidence: IV.

• 대한한방내과학회지
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• 제45권3호
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• pp.456-477
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• 2024

Background: Asthma and chronic obstructive pulmonary disease (COPD) both require long-term management, and patients with asthma-COPD overlap (ACO) need comprehensive and prolonged care beyond pharmacotherapy. However, due to limited research on ACO, treatment strategies and long-term outcomes remain unclear. This highlights the need for further multidisciplinary research to improve ACO treatment and prognosis. Case Presentation: This case report describes a patient who presented with symptoms of cough, sputum, wheezing, dyspnea, and oral dryness. The patient was diagnosed with ACO and received a combination of Korean medicine treatments alongside standard asthma medication for 15 days. Standardized tools were used to evaluate symptoms and quality of life, respectively. After treatment, Medical Research Council scale, Leicester cough questionnaire Korean-Version and Numerical Rating Score demonstrated clinically meaningful improvement, and Total IgE and Eosinophils were slightly decreased. Conclusion: This case suggests Korean medicine treatments might be effective in managing symptoms in patients with ACO and enhancing quality of life.

• 한국간담췌외과학회지
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• 제26권3호
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• pp.220-228
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• 2022

Backgrounds/Aims: In Korea, pancreatic cancer and "gallbladder and extrahepatic bile duct cancer" were ranked the 8th and 9th most frequent cancers in 2019 and the 4th and 6th most common causes of cancer deaths in 2020, respectively. Methods: This review provides national cancer statistics and secular trends of 207,521 patients with gallbladder (n = 44,178), extrahepatic bile duct (n = 61,856), and pancreatic cancer (n = 101,487) between 1999 and 2019 in Korea. Results: The crude incidence rate in both sexes increased in the gallbladder (2.8 to 5.4 per 100,000), extrahepatic bile duct (3.6 to 9.0), and pancreatic cancer (5.5 to 15.8). The age-standardized incidence rate in both sexes significantly increased in the extrahepatic bile duct (3.7 to 4.1) and pancreatic (5.6 to 7.6) cancers but decreased in gallbladder cancer (2.9 to 2.4). The overall 5-year relative survival rate increased in the gallbladder (21.8% to 30.6%), extrahepatic bile duct (23.1% to 27.5%), and pancreatic (8.5% to 13.3%) cancers. Between 2006 and 2019, the proportion of localized or regional stages remained stable. The proportion of surgical treatment within the first 4 months after diagnosis was relatively higher in the gallbladder (42.2%) and extrahepatic bile duct (45.9%) cancers than in pancreatic cancer (22.2%). Conclusions: The crude incidence and mortality rates of the gallbladder, extrahepatic bile duct, and pancreatic cancer are steadily increasing in Korea, and the prognosis remains poor. Early detection, active application of surgical treatment, and minimization of the proportion of untreated patients are required to improve the survival rates of these cancers.

• 동의신경정신과학회지
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• 제35권2호
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• pp.153-162
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• 2024

Objectives: Among OECD countries, South Korea has been having the highest suicide rate since 2018, with 24.1 deaths per 100,000 people reported in 2020. The objectie of this study was to examine the use of generative artificial intellicence (AI) chatbots to train third-year Korean medicine (KM) students in conducting suicide risk assessments for patients with depressive disorders to train students for their clinical practice skills. Methods: The Claude 3 Sonnet model was utilized for chatbot simulations. Students performed mock consultations using standardized suicide risk assessment tools including Ask Suicide-Screening Questions (ASQ) tool and ASQ Brief Suicide Safety Assessment. Experiences and attitudes were collected through an anonymous online survey. Responses were rated on a 1~5 Likert scale. Results: Thirty-six students aged 22~30 years participated in this study. Their scores for interest and appropriateness (4.66±0.57), usefulness (4.60±0.61), and overall experience (4.63±0.60) were high. Their evaluation of the usability of artificial intelligence chatbot was also high at 4.58±0.70 points. However, their trust in chatbot responses (Q12) was lower (3.86±0.99). Common issues related to dissatisfaction included conversation disruptions due to token limits and inadequate chatbot responses. Conclusions: This is the first study investigating generative AI chatbots for suicide risk assessment training in KM education. Students reported high satisfaction, although their trust in chatbot accuracy was moderate. Technical limitations affected their experience. These preliminary findings suggest that generative AI chatbots hold promise for clinical training, particularly for education in psychiatry. However, improvements in response accuracy and conversation continuity are needed.

• International Journal of Advanced Culture Technology
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• 제12권3호
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• pp.37-46
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• 2024

This study was designed to identify factors affecting polyclinic (clinical practice) during COVID-19. Fourth-year medical students at K Medical University in Daejeon, South Korea were recruited, and 64 medical students ultimately agreed to participate in a survey about polyclinics in a regional emergency center over 4 weeks. Satisfy answers for 5^th grade and 6^th grade was 15 (53.6%) and 13 (46.4%) respectively. Dissatisfy answers of observation of the ICU for 5^th grade and 6^th grade was 10 (27.8%) and 26 (72.2%) respectively. Thus, there were more satisfy answers in 5^th grade and less satisfy answers in 6^th grade(p<0.05). Based on the results of confirming significance for regression coefficient, several factors influencing the polyclinic were identified, and the following categories showed statistical significance (p<0.05): for 6^th grade, satisfy answers of the clinic hours showed 3.656 times more than dissatisfy answers, exempt from the operation room showed 21.596 times more than dissatisfy answers, observation of the intensive unit care (ICU) showed 0.054 times less than dissatisfy answers, and cares of the COVID-19 patients showed 6.962 times more than dissatisfy answers. We suggest that hybrid or virtual medical education such as the polyclinic utilizing standardized patients (SP) or augmented reality (AR) technologies at the virtual hospital or the real hospital. More medical students would be encouraged to participate the problem-based learning (PBL) or team-based learning (TBL) in so-called 'hybrid or virtual' polyclinic.

• Clinical Nutrition Research
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• 제13권3호
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• pp.186-200
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• 2024

Meta-analyses have been conducted with conflicting results on this topic. Due to missing several eligible studies in previous meta-analysis by Lam et al., we conducted an extensive systematic review and dose-response meta-analysis of randomized controlled trials in this regard. A comprehensive search was conducted across various databases, including MEDLINE/PubMed, ISI Web of Knowledge, Scopus, and Google Scholar, until November 2023. Based on the analysis of 33 studies comprising 2,047 individuals, it was found that there was a significant increase in body weight for each 1 g/day increase in omega-3 lipids (standardized MD [SMD], 0.52 kg; 95% confidence interval [CI], 0.31, 0.73; I² = 95%; Grading of Recommendations Assessment, Development and Evaluation [GRADE] = low). Supplementation of omega-3 fatty acids did not yield a statistically significant impact on body mass index (BMI) (SMD, 0.12 kg/m²; 95% CI, -0.02, 0.27; I² = 79%; GRADE = very low), lean body mass (LBM) (SMD, -0.02 kg; 95% CI, -0.43, 0.39; I² = 97%; GRADE = very low), fat mass (SMD, 0.45 kg; 95% CI, -0.25, 1.15; I² = 96%; GRADE = low), and body fat (SMD, 0.30%; 95% CI, -0.90, 1.51; I² = 96%; GRADE = very low). After excluding 2 studies, the findings were significant for BMI. Regarding the results of the dose-response analysis, body weight increased proportionally by increasing the dose of omega-3 supplementation up to 4 g/day. Omega-3 fatty acid supplementation can improve body weight, but not BMI, LBM, fat mass, or body fat in cancer patients; large-scale randomized trials needed for more reliable results.

• 대한한의학회지
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• 제25권4호
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• pp.139-146
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• 2004

Objective : While the demand for herbal medicine has increased continuously, scientific data attesting to pharmacological activity are still insufficient. One important reason, especially in child patients, is the shortage of standardized instruments for clinical research. This study was designed to develop a scale to assess the effect of herbal medicine in children. Methods : The authors chose Gami-jiwhangtang (GJT) as a standard formulation and developed a scale, Bahn's Drug Evaluation Scale (BaDES), for this experiment. Forty-two healthy children, 7 and 8 years old, living in Seoul, Korea, volunteered to use GJT. The experimental group received GJT for 6 weeks, whereas the control group received no medicine. The children's mothers in both groups completed the BaDES on the sixth and twelfth week after GJT was commenced. Results : The experimental group showed a significant improvement in overall physical condition and gastrointestinal function as compared with the control group. Conclusion : These results suggest that BaDES may be a useful assessment tool for measuring the effect of herbal medicine.

• 동의신경정신과학회지
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• 제25권1호
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• pp.73-84
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• 2014

The purpose of this study was to introduce a PTSD patient who experienced significant effects of mindfulness meditation and Ii-Gyeung-Byun-Qi therapy. Our psychotherapy was executed five times a week for the 14-year-old male patient who attended middle school and was diagnosed by DSM-IV Diagnostic Criteria for PTSD, and then the MMPI-A was evaluated to determine the effects after 3 months. The results showed normal profiles of MMPI-A validity scales and Clinical Scales profile after his treatment, positive changes in content scales, and significant decreases of PSYC (psychoticism) and NEGE (negative emotionality) in PSY-5 scales. This study made through a case report on the treated psychotherapy for PTSD by the applications of modern psychological techniques in the Korean psychotherapy. We expected that this case report will have a role in development of standardized psychotherapy programs for PTSD.