• The Journal of Korean Medicine
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• v.42 no.4
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• pp.61-74
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• 2021

Objectives: This study aimed to analyse: 1) the clinical effectiveness and safety of traditional Korean Medicine (TKM) and frequency of TKM therapies used and their relationship with conventional treatments. Methods: This prospective observational study enrolled children with cerebral palsy (CP) aged 6-78 months (n=126). The children who used herbal medication for >30 days or acupuncture treatment >12 sessions within 6 months were defined as the integrated rehabilitation (IR) group; the remaining participants were included in the conventional rehabilitation (CR) group. Results: Changes in the Gross Motor Function Measure-66 (GMFM-66) were greater in the IR group (6.4±6.1) than in the CR group (4.6±5.8). The reduction in the number of other health problems was greater in the IR group than in the CR group. The GMFM-66 improvement was greatest in gross motor function classification system level 1. There was no between-group difference in the frequency of rehabilitation therapy (10.9±6.6 and 12.0±9.9 in the IR and CR groups, respectively). Conclusion: TKM may offer additional benefits in terms of the GMFM-66 score and other health problems. However, there is a need for further randomized controlled trials involving a restricted CP type and a controlled treatment type and intensity to confirm these findings.

• The Journal of Korean Obstetrics and Gynecology
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• v.35 no.3
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• pp.56-73
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• 2022

Objectives: This study was aimed to review the effect of acupuncture for insomnia in climacteric syndrome. Methods: Researchers searched data through 5 online databases up to December 2021. The data was limited to randomized controlled trial studies on patients diagnosed with insomnia in climacteric syndrome. Results: 8 Randomized controlled trials were included in this study. 6 of studies were published in Chinese, in China. 2 were published in English. Intervention of treatment group were composed of simple acupuncture. Intervention of control group were made up with Estazolam, Alprazolam, Lorazepam and sham-acupuncture. Outcome measurements were Total effective rate, Pittsburgh Sleep Quality Index (PSQI), Kupperman index, Menopause Quality of Life scales (Men-QoL), the level of hormones (E2, FSH, LH) etc. In all outcome measurements, treatment group were more effective than control group and it was statistically significant. Conclusions: Acupunture therapy is effective for treating insomnia in climacteric syndrome. Pittsburgh Sleep Quality Index (PSQI) is most frequently used for sleep assessment indicator. 神門 (HT7) is the most frequently used acupoint for treatment group. However because insomnia in climacteric syndrome is easy to recur, additional long-term research is needed.

• Journal of Radiation Protection and Research
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• v.12 no.2
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• pp.37-50
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• 1987

The exposure of the population in the United States to ionizing radiation has recently been evaluated by the National Council on Radiation Protection and Measurements (NCRP). This was done by constituting six organizational groups to address various phases of the work and the results of this work are summarized in this article. The article is based on the report, by the same title, which is scheduled for publication by the NCRP in September, 1987. The six organizational groups are titled Radiation Exposure from Consumer Products, Natural Background Radiation, Radiation Associated with Medical Examinations, Radiation Received by Radiation Employees, Public Exposure from Nuclear Power, and Exposure from Miscellaneous Environmental Sources. These titles are descriptive of the subject areas covered by each of these separate groups. The data evaluated are for the years 1977-1984 with the majority of the data being for the period 1980-1982. Summary information is presented and discussed for the number of people exposed to given sources, the effective dose equivalent, the average effective dose equivalent to the U.S. population, and the genetically significant dose equivalent. The average annual effective dose equivalent from all sources to the U.S. population is approximately 3.6 mSv (360 mrem). Exposures to natural sources make the largest contribution to this total. Radon and radon decay products contribute 2.0 mSv (200 mrem) whereas the other naturally occurring radionuclides contribute 1.0 mSv (100 mrem). Among man-made or enhanced sources, medical exposures make the largest additional contributions, namely 0.39 mSv (39 mrem) for diagnosis and 0.14 mSv (14 mrem) for nuclear medicine. It was not possible to evaluate exposures for therapy. Most of the other sources of population exposure, including nuclear power and consumer products, are minor. A possible exception would be the use of tobacco products. These exposures are discussed in relation to a negligible individual risk level of $10{\mu}Sv/y$ (1 mrem/y). The NCRP considers exposures below the negligible individual risk level as trivial and as such should be dismissed.

• Journal of Digestive Cancer Research
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• v.4 no.1
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• pp.1-9
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• 2016

The abundance of multi-drug resistance ATPase binding cassette and deranged self-renewal pathways shown in cancer stem cells (CSCs) played a crucial role in tumorigenesis, tumor resistance, tumor recurrence, and tumor metastasis. Therefore, elucidation of CSCs biology can improve diagnosis, enable targeted treatment, and guide the follow up of GI cancer patients. In order to achieve chemoquiescence, seizing cancer through complete ablation of CSCs, CSCs are rational targets for the design of interventions that will enhance responsiveness to traditional therapeutic strategies and contribute in the prevention of local recurrence as well as metastasis. However, current cancer treatment strategies fail to either detect or differentiate the CSCs from their non-tumorigenic progenies mostly due to the absence of specific biomarkers and potent agents to kill CSCs. Recent advances in knowledge of CSCs enable to produce several candidates to ablate CSCs in gastrointestinal (GI) cancers, especially cancers originated from inflammation-driven mutagenesis such as Barrett's esophagus (BE), Helicobacter pylori-associated gastric cancer, and colitis-associated cancer (CAC). Our research teams elucidated through revisiting old drugs that proton pump inhibitor (PPI) and potassium competitive acid blocker (p-CAB) beyond authentic acid suppression, chloroquine for autophage inhibition, sonic hedgehog (SHH) inhibitors, and Wnt/β-catenin/NOTCH inhibitor can ablate CSCs specifically and efficiently. Furthermore, nanoformulations of these molecules could provide an additional advantage for more selective targeting of the pathways existing in CSCs just like current molecular targeted therapeutics and sustained action, while normal stem cells intact. In this review article, the novel approach specifically to ablate CSCs existing in GI cancers will be introduced with the introduction of explored mode of action.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.4
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• pp.155-162
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• 2023

PURPOSE: The primary objective of this study was to develop a virtual reality-based vestibular rehabilitation system to enhance balance perception, target rehabilitation specialists, and evaluate its usability. A key goal was establishing a system refinement strategy based on the collected data. METHODS: We conducted a study involving ten adults aged 10 to 29 in Gwangju Metropolitan City to evaluate the usability of a virtual reality-based vestibular rehabilitation system to enhance balance perception. After introducing the product and explaining its use to the participants, balance assessments and training were conducted using computerized dynamic posturography (CDP) (also called the test of balance [TOB]). Subsequently, participants were given a questionnaire to evaluate subjective stability, operability, and satisfaction. Frequency analysis was utilized to determine the frequency of the variable values of the measurement items in the survey for descriptive statistics. RESULTS: We found that the average usability score was 2.587. When broken down by category, stability received an average rating of 2.725, operability scored an average of 2.783, and satisfaction averaged 2.454. These findings suggest that most participants experienced positive sentiments and considerable satisfaction. CONCLUSION: The study successfully developed a virtual reality-based vestibular rehabilitation system, which was an improvement over the previous model and addressed its shortcomings. The results show that users with vestibular impairments are satisfied and more engaged with this system, indicating that additional studies are warranted.

• Journal of Chest Surgery
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• v.57 no.2
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• pp.152-159
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• 2024

Background: Anastomotic leakage (AL) following esophagectomy represents a serious complication that often results in prolonged hospitalization and necessitates repeated interventions, including nothing-by-mouth (NPO) restriction, endoscopic vacuum therapy (EVT), or surgical repair. In this study, we evaluated the patterns and outcomes of AL treatment. Methods: We retrospectively reviewed the medical records of patients who underwent esophagectomy for esophageal cancer at a single center between 2003 and 2020. Of 3,096 examined cases, 181 patients (5.8%) with AL were included in the study: 114 patients (63%) with cervical anastomosis (CA) and 67 (37%) with intrathoracic anastomosis (TA). Results: The incidence of AL was 11.9% in the CA and 3.2% in the TA group (p<0.001). Among patients with CA who developed AL, 87 (76.3%) were managed with NPO, 15 (13.2%) with EVT, and 12 (10.5%) with surgical repair. Over 90% of patients with cervical AL resumed an oral diet by the time of discharge, regardless of treatment method. Among patients with TA and AL, 36 (53.7%) received NPO, 25 (37.7%) underwent EVT, and 6 (9%) required surgery. Of these, 34 patients who were managed with NPO and 19 with EVT could resume an oral diet. However, only 2 patients who underwent surgery resumed an oral diet, and 2 patients required additional EVT. Conclusion: Although patients with CA displayed a higher incidence of AL, their rate of successful oral intake exceeded that of those with TA, regardless of treatment method. Among patients exhibiting AL with TA, EVT was more commonly employed than in CA cases, and it appears effective.

• PNF and Movement
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• v.22 no.1
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• pp.13-21
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• 2024

Purpose: This study investigated the effects of side walking training combined with squats on the balance and gait ability of stroke patients. The purpose of this study was to provide fundamental data regarding the use of side walking training combined with squats among stroke patients. Methods: Thirty patients with stroke were randomly divided into an experimental group (n=15) that underwent side walking training combined with squats and a control group (n=15) that performed general rehabilitation exercises. Both groups performed their respective exercises for 30 minutes, five times a week for six weeks. Balance was assessed using the functional reach test and timed up and go test, while gait ability was evaluated using the 10-meter walk test. A paired t-test was performed to compare within-group changes before and after the intervention. Differences between the experimental and control groups were analyzed using an independent t-test. For all tests, the level of statistical significance was set at α=0.05. Results: After the exercise, significant within-group improvements in balance and gait ability were observed in both the experimental and control groups (p<0.05). There was also a significant between-group difference in balance and gait ability following the intervention (p<0.05). Conclusion: While general rehabilitation is commonly employed in treating stroke patients and is relatively effective, the application of side walking training combined with squats may offer additional benefits in terms of improving balance and gait ability in these patients.

• Korean Journal of Radiology
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• v.23 no.1
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• pp.60-67
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• 2022

Objective: To categorize multiparametric MRI features of Bacillus Calmette-Guérin (BCG)-related granulomatous prostatitis (GP) and discover potential manifestations for its differential diagnosis from prostate cancer. Materials and Methods: The cases of BCG-related GP in 24 male (mean age ± standard deviation, 66.0 ± 9.4 years; range, 50-88 years) pathologically confirmed between January 2011 and April 2019 were retrospectively reviewed. All patients underwent intravesical BCG therapy followed by a MRI scan. Additional follow-up MRI scans, including diffusion-weighted imaging (DWI), were performed in 19 patients. The BCG-related GP cases were categorized into three: A, B, or C. The lesions with diffusion restriction and homogeneous enhancement were classified as type A. The lesions with diffusion restriction and a poorly enhancing component were classified as type B. A low signal intensity on high b-value DWI (b = 1000 s/mm²) was considered characteristic of type C. Two radiologists independently interpreted the MRI scans before making a consensus about the types. Results: The median lesion size was 22 mm with the interquartile range (IQR) of 18-26 mm as measured using the initial MRI scans. The lesion types were A, B, and C in 7, 15, and 2 patients, respectively. Cohen's kappa value for the inter-reader agreement for the interpretation of the lesion types was 0.837. On the last follow-up MRI scans of 19 patients, the size decreased (median, 5.8 mm; IQR, 3.4-8.5 mm), and the type changed from A or B to C in 11 patients. The lesions resolved in four patients. In five patients who underwent prostatectomy, caseous necrosis on histopathology matched with the non-enhancing components of type B lesions and the entire type C lesions. Conclusion: BCG-related GP demonstrated three imaging patterns on multiparametric MRI. Contrast-enhanced T1-weighted imaging and DWI may play a role in its differential diagnosis from prostate cancer.

• Journal of Oriental Neuropsychiatry
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• v.35 no.1
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• pp.15-26
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• 2024

Objectives: The objective of this study is to develop a specialized clinical research protocol for acupuncture treatment specifically designed for disaster survivors based on insights from an expert survey. Methods: An expert panel comprising specialists in neuropsychiatry, acupuncture, and clinical research methodology was assembled. Initial data to inform the clinical research protocol design was collected utilizing open-ended responses, multiple-choice questions, and a 5-point Likert scale to gauge agreement levels. Next, this data was disseminated to a panel of experts. A cohesive clinical research protocol was then formulated during a core panel meeting by integrating insights from a panel of 10 experts. Results: The protocol developed herein entails a non-randomized controlled study involving participants aged 19~64 years old who have been identified as high-risk or cautious according to the National Trauma Center screening test. The study design includes the establishment of an active control group, which allows for the assessment of an additional effect through comparison with conventional therapy. The selected acupuncture approach involves a combination of manual acupuncture and ear acupuncture. For clinical outcome assessment, the Clinician-Administered Posttraumatic Stress Disorder Scale for DSM-5 was proposed to gauge trauma symptoms. Representative scales for various domains such as depression, anxiety, anger, insomnia, pain, and quality of life were also provided for reference. Conclusions: The developed protocol is anticipated to streamline the swift design and initiation of clinical trials during disaster scenarios. It is also designed to be scalable, thereby enabling its application in both non-randomized control group studies and single-group before-and-after comparisons.

• Korean Journal of Radiology
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• v.1 no.4
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• pp.198-207
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• 2000

Uterine cervical carcinoma is one of the most common malignant tumors occurring in females. After primary treatment, patients are usually followed up with CT or MRI and the findings of these modalities may be the first sign of recurrent disease. Because earlier additional treatment by chemotherapy or radiation therapy may improve the prognosis, the early detection of recurrent cervical carcinoma is clinically important. In this article, we review the CT and MR imaging findings of recurrent uterine cervical carcinoma, and assign them to one of four groups: a) recurrence at the primary site, involving the intrapelvic organs, b) extension to the pelvic side-wall, c) metastases to pelvic and extrapelvic lymph nodes, or d) metastases to distant organs. A further contribution of CT and MR imaging is the detection of hydronephrosis due to ureteral obstruction. The cases in each group are illustrated and discussed, and since an awareness of the spectrum of imaging findings of recurrent cervical carcinoma is likely to lead to its early detection, radiologists should be familiar with the information presented.