• Physical Therapy Rehabilitation Science
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• 제10권1호
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• pp.22-31
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• 2021

Objective: This review aims to analyze the effects of electromechanically assisted walking in patients with cerebral palsy(CP). Design: A systematic review and meta-analysis. Methods: We reviewed systematically using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist guidelines. The inclusion criteria for this study were all CP patients. The intervention was electromechanically assisted walking. The outcome measures included gait parameters, function, spasticity. Studies excluded from this review were excluded from the review if they were non-English languages and if the study was not published as a full report, and if they were not randomized controlled trials (RCTs) designs. The RevMan 5.4 program was used to evaluate and explain the results. The risk of bias was evaluated independently by two reviewers. The quantitative meta-analysis, including mean differences (MD) and associated standard deviations (SD) from baseline and follow-up assessments, were recorded. Results: A total of 634 articles were searched. Two hundred eighty-nine duplicate articles were excluded, and 345 of 634 originals were left for selection. Of these 74 papers, 44 were out of topic, and 19 reported no mean or standard deviation values. And one was a non-experimental study. Finally, ten studies were included. All 10 RCTs of electromechanically assisted walking were analyzed. The meta-analysis showed a significant improvement in gait cycle (95% CI (confidence intervals), 0.09 to 0.19, I2=0%), Gross Motor Function Measure (GMFM) D (95% CI, 3.27 to 13.17, I2=0%) and GMFM E (95% CI, 0.22 to 6.41, I2=0%). Conclusions: Electromechanically assisted training helps in walking in patients with CP.

• Journal of Korean Neurosurgical Society
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• 제64권5호
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• pp.740-750
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• 2021

Objective : Retrograde suction decompression (RSD) is an adjuvant technique used for the microsurgical treatment of large and giant internal carotid artery (ICA) aneurysms. In this study, we analyzed the efficacy and safety of the RSD technique for the treatment of large and giant ICA aneurysms relative to other conventional microsurgical techniques. Methods : The aneurysms were classified into two groups depending on whether the RSD method was used (21 in the RSD group vs. 43 in the non-RSD group). Baseline characteristics, details of the surgical procedure, angiographic outcomes, clinical outcomes, and procedure-related complications of each group were reviewed retrospectively. Results : There was no significant difference in the rates of complete neck-clipping between the RSD (57.1%) and non-RSD (67.4%) groups. Similarly, there was no difference in the rates of good clinical outcomes (modified Rankin Scale score, 0-2) between the RSD (85.7%) and non-RSD (81.4%) groups. Considering the initial functional status, 19 of 21 (90.5%) patients in the RSD group and 35 of 43 (81.4%) patients in the non-RSD group showed an improvement or no change in functional status, which did not reach statistical significance. Conclusion : In this study, the microsurgical treatment of large and giant intracranial ICA aneurysms using the RSD technique obtained competitive angiographic and clinical outcomes without increasing the risk of procedure-related complications. The RSD technique might be a useful technical option for the microsurgical treatment of large and giant intracranial ICA aneurysms.

• 셀메드
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• 제11권4호
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• pp.17.1-17.4
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• 2021

Episiotomy is the commonest obstetrics intervention in the world to reduce severe perineal injuries. Its prevalence is 43% to 100% in primiparous women in Asia. Further, worldwide approximately 10-95% of pregnant women undergo episiotomy incision during birth. Delay in wound healing probably increases the risk of wound infection, changes the muscular structure, and ultimately causes muscle tone loss. So, wound care is of specific significance to postnatal maternal outcomes. Hence, this case study aimed to evaluate the effect of Marham-i-Raal in episiotomy wound healing and pain relief. The study was conducted in eleven postpartum primi or multipara pregnant women aged between group 19 and 35 years with term gestational age, singleton pregnancy in a cephalic presentation who had a normal vaginal delivery with mediolateral episiotomy, without a perineal tear, and perineal hematoma. Externally, application of Marham-i-Raal 2g on episiotomy incisional wound, twice a day for 10 days was advised. Wound healing of episiotomy and pain intensity was assessed with REEDA ["redness, oedema, ecchymosis, discharge and approximation of the edges"] scoring and VAS scoring for pain intensity respectively. At one hour (baseline), the REEDA mean score of eleven patients was 3.90±1.04 whereas on day 7-10 it was 0.18±0.40 with statistically significant difference (p<0.001). The VAS mean score at one hour was 6.90±1.22 whereas on day 7-10 it was 0.72±0.78 with a statistically significant difference (p<0.001). Marham-i-Raal would be effective in episiotomy wound healing and reducing pain intensity. Further, randomized double-blind controlled trials in large sample size are recommended.

• Journal of Korean Neurosurgical Society
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• 제65권1호
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• pp.22-29
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• 2022

Objective : Despite many advancements in endovascular treatment, the benefits of mechanical thrombectomy (MT) in patients with large infarctions remain uncertain due to hemorrhagic complications. Therefore, we aimed to investigate the efficacy and safety of recanalization via MT within 6 hours after stroke in patients with large cerebral infarction volumes (>70 mL). Methods : We retrospectively reviewed the medical data of 30 patients with large lesions on initial diffusion-weighted imaging (>70 mL) who underwent MT at our institution within 6 hours after stroke onset. Baseline data, recanalization rate, and 3-month clinical outcomes were analyzed. Successful recanalization was defined as a modified treatment in cerebral ischemia score of 2b or 3. Results : The recanalization rate was 63.3%, and symptomatic intracerebral hemorrhage occurred in six patients (20%). The proportion of patients with modified Rankin Scale (mRS) scores of 0-3 was significantly higher in the recanalization group than in the non-recanalization group (47.4% vs. 9.1%, p=0.049). The mortality rate was higher in the non-recanalization group, this difference was not significant (15.8% vs. 36.4%, p=0.372). In the analysis of 3-month clinical outcomes, only successful recanalization was significantly associated with mRS scores of 0-3 (90% vs. 50%, p=0.049). The odds ratio of recanalization for favorable outcomes (mRS 0-3) was 9.00 (95% confidence interval, 0.95-84.90; p=0.055). Conclusion : Despite the risk of symptomatic intracerebral hemorrhage, successful recanalization via MT 6 hours after stroke may improve clinical outcomes in patients with large vessel occlusion.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권6호
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• pp.453-460
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• 2022

Purpose: Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is a congenital anomaly that can cause frequent digestive and nutritional problems, even after repair. The most common complication is anastomotic stricture, for which reoperation or balloon dilatation is performed. This study aimed to evaluate the postoperative complications of EA and the role of endoscopic balloon dilatation (EBD) in cases of anastomotic stricture. Methods: We retrospectively analyzed patients diagnosed with EA with or without TEF between January 2000 and February 2021. Patients' baseline characteristics, associated anomalies, and postoperative complications were reviewed. Results: Among 26 patients, 14 (53.8%) were male, 12 (46.2%) had coexisting anomalies, and the median follow-up was 6.1 years (range, 1.2-15.7 years). In univariate analysis, prematurity, low birth weight, and long-gap EA were associated with postoperative complications in 12 (46.2%) patients. Among the 10 (38.5%) patients with anastomotic stricture, nine (90.0%) required EBD. Regarding the first EBD, it was performed at a median of 3.3 months (range, 1.2-7.6 months) post-repair, while the average patient weight was 4.6 kg. The mean diameter ranged from 3.3 to 9.1 mm without major complications. In univariate analysis, long-gap EA alone was significantly associated with EBD. Conclusion: Approximately half of the patients experienced complications after EA repair. In particular, patients with a long-gap EA had a significantly increased risk of complications, such as anastomotic strictures. EBD can be safely used, even in infants.

• 여성건강간호학회지
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• 제28권3호
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• pp.250-263
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• 2022

Purpose: The purpose of this study was to develop a webtoon education program on preventive self-management related to premature labor (PSM-PL) for women of childbearing age, to evaluate its effects, and to assess the usability of webtoon education for women of childbearing age. Methods: The study design was a stratified randomized trial with repeated measures. The participants were Korean women of childbearing age (between the ages of 19 and 49 years), with 49 participants each. The preventive health management self-efficacy related to premature labor (PHMSE-PL) scale, the preventive self-management knowledge related to premature labor (PSMK-PL) scale, and usability of webtoon education were assessed. The intervention group read six episodes of the PSM-PL webtoon within 2 days after clicking an online link. The control group did not receive anything but was given the webtoon after the last measurement. To test the effect of the repeatedly measured variables, a generalized estimating equation model was used. Results: The experimental group had statistically significantly greater increases in PHMSE-PL and PSMK-PL scores from baseline to immediately after and 2 weeks later than the control group. The average score for usability of webtoon education was high (4.52; standard deviation, 0.62) on a scale of 1-5. Conclusion: This webtoon education program on PSM-PL was a feasible and acceptable program that increased self-efficacy and knowledge of preventive health management of premature labor in women of childbearing age. Future studies that adopt a webtoon format can be beneficial for childbearing women with other risk factors.

• Journal of Chest Surgery
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• 제55권3호
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• pp.197-205
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• 2022

Background: The integrated design of the HeartMate 3 (Abbott Laboratories, Chicago, IL, USA) affords flexibility to place the pump within the pericardium or thoracic cavity. We sought to determine whether the presence of a left ventricular assist device (LVAD) in either location has a meaningful impact on overall patient outcomes. Methods: A retrospective cohort study was conducted of all 165 patients who received a HeartMate 3 LVAD via a median sternotomy from November 2014 to August 2019 at our center. Based on operative reports and imaging, patients were divided into intrapleural (n=81) and intrapericardial (n=84) cohorts. The primary outcome of interest was in-hospital mortality, while secondary outcomes included postoperative complications, cumulative readmission incidence, and 3-year survival. Results: There were no significant between-group differences in baseline demographics, risk factors, or preoperative hemodynamics. The overall in-hospital mortality rate was 6%, with no significant difference between the cohorts (9% vs. 4%, p=0.20). There were no significant differences in the postoperative rates of right ventricular failure, kidney failure requiring hemodialysis, stroke, tracheostomy, or arrhythmias. Over 3 years, despite similar mortality rates, intrapleural patients had significantly more readmissions (n=180 vs. n=117, p<0.01) with the most common reason being infection (n=68/165), predominantly unrelated to the device. Intrapleural patients had significantly more infection-related readmissions, predominantly driven by non-ventricular assist device-related infections (p=0.02), with 41% of these due to respiratory infections compared with 28% of intrapericardial patients. Conclusion: Compared with intrapericardial placement, insertion of an intrapleural HM3 may be associated with a higher incidence of readmission, especially due to respiratory infection.

• Tuberculosis and Respiratory Diseases
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• 제84권3호
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• pp.188-199
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• 2021

Background: Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease with increased prevalence in the elderly. Telomeres are repetitive DNA sequences found at the end of the chromosome, which progressively shorten as cells divide. Telomere length is known to be a molecular marker of aging. This study aimed to assess the relationship between telomere length and the risk of COPD, lung function, respiratory symptoms, and emphysema index in Chronic Obstructive Pulmonary Disease in Dusty Areas (CODA) cohort. Methods: We extracted DNA from the peripheral blood samples of 446 participants, including 285 COPD patients and 161 control participants. We measured absolute telomere length using quantitative real-time polymerase chain reaction. All participants underwent spirometry and quantitative computed tomography scan. Questionnaires assessing respiratory symptoms and the COPD Assessment Test was filled by all the participants. Results: The mean age of participants at the baseline visit was 72.5±7.1 years. Males accounted for 72% (321 participants) of the all participants. The mean telomere length was lower in the COPD group compared to the non-COPD group (COPD, 16.81±13.90 kb; non-COPD, 21.97±14.43 kb). In COPD patients, 112 (75.7%) were distributed as tertile 1 (shortest), 91 (61.1%) as tertile 2 and 82 (55%) as tertile 3 (longest). We did not find significant associations between telomere length and lung function, exacerbation, airway wall thickness, and emphysema index after adjusting for sex, age, and smoking status. Conclusion: In this study, the relationship between various COPD phenotypes and telomere length was analyzed, but no significant statistical associations were shown.

• Physical Therapy Rehabilitation Science
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• 제9권4호
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• pp.215-221
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• 2020

Objective: Tension-type headaches usually occur with temporomandibular disorder, which increases the risk of the chronic tension-type headaches. This study was conducted to investigate the effect of additional temporalmandibular therapy compared to cerivcal joint therapy for tension-type headaches with pericranial tenderness. Design: Randomized controlled trial. Methods: Forty-one patients with chronic tension-type headaches and pericranial tenderness were randomized into the 3 groups, such as the temporomandibular joint therapy group (TMJT group, n=14), cervical manual therapy group (CMT group, n=14) and conservative therapy group (CT group, n=13). All patients were assessed at baseline and after each intervention during the three sessions. The participants in the TMJT group received the temporomadibular joint treatment and cervical manual therapy for 30 minutes, once a week, for 3 weeks. The participants in the CMT group received the cervical manual therapy, and those in the CT group received modalities during same time period. The outcome measurements used were the intensity of headaches measured on the Visual Analogue Scale (VAS), quality of life measured with the Headache Impact Test (HIT-6), and function of the cervical spine using the Neck Diability Index (NDI). Results: The TMJT group that received temporomandibular joint treatment and cervical manual therapy showed a significant decrease in VAS, HIT-6, and NDI compared with the other 2 groups (p<0.05). Conclusions: This study suggected that temporomandibular joint treatment combined with cervical manual therapy was more effective for the chronic tension-type headaches with pericranial tenderness than the usual cervical therapy alone.

• 한국컴퓨터정보학회논문지
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• 제27권12호
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• pp.161-169
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• 2022

최근 들어 모바일 디바이스와 GPS(Global Positioning System)의 발전으로 다양한 위치 기반 서비스(Location-Based Servises, LBS)를 활용할 수 있게 되었다. LBS 사용자는 서비스를 이용하기 위해 자신의 위치 정보를 서비스 제공자에게 노출한다. 이 과정에서 개인의 민감한 정보를 침해할 가능성이 있으므로 사용자의 위치 데이터를 변조하여 프라이버시를 보존할 수 있는 Geo-indistinguishability(Geo-Ind) 기법이 많이 활용되고 있다. 그러나 Geo-Ind 기법으로 인하여 사용자로부터 변조된 데이터를 수집하는 경우, LBS 제공자는 사용자 분포에 대한 정확한 정보를 얻을 수 없다. 그러므로 본 논문에서는 Geo-Ind 기법을 이용하여 사용자로부터 수집한 변조된 위치 데이터로부터 사용자 분포에 대한 정보를 정확하게 계산하기 위한 방법을 제안한다. 특히, Expectation-Maximization(EM) 기법을 이용하여 변조된 데이터로부터 사용자의 위치 분포를 정확하게 예측하기 위한 기법을 제안한다. 또한 실제 데이터를 이용해 제안 기법의 우수성을 입증한다.