• Tuberculosis and Respiratory Diseases
• /
• v.85 no.1
• /
• pp.11-17
• /
• 2022

Background: In asthma, consistent control of chronic airway inflammation is crucial, and the use of asthma-controller medication has been emphasized. Our purpose in this study is to compare the incidence of acute exacerbation and healthcare costs related to the use of asthma-controller medication. Methods: By using data collected by the National Health Insurance Review and Assessment Service, we compared one-year clinical outcomes and medical costs from July 2014 to June 2015 (follow-up period) between two groups of patients with asthma who received different prescriptions for recommended asthma-controller medication (inhaled corticosteroids or leukotriene receptor antagonists) at least once from July 2013 to June 2014 (assessment period). Results: There were 51,757 patients who satisfied our inclusion criteria. Among them, 13,702 patients (26.5%) were prescribed a recommended asthma-controller medication during the assessment period. In patients using a recommended asthma-controller medication, the frequency of acute exacerbations decreased in the follow-up period, from 2.7% to 1.1%. The total medical costs of the controller group decreased during the follow-up period compared to the assessment period, from $3,772,692 to $1,985,475. Only 50.9% of patients in the controller group used healthcare services in the follow-up period, and the use of asthma-controller medication decreased in the follow-up period. Conclusion: Overall, patients using a recommended asthma-controller medication showed decreased acute exacerbation and reduced total healthcare cost by half.

• Archives of Plastic Surgery
• /
• v.49 no.3
• /
• pp.397-404
• /
• 2022

Background Excessive use of corticosteroids therapy along with gross immunocompromised conditions in the novel coronavirus disease 2019 (COVID-19) pandemic has raised the risks of contracting opportunistic fungal infections. Here, we describe our experience with the implementation of a surgical protocol to treat and reconstruct rhino-orbital-cerebral mucormycosis. Methods A retrospective review of our prospectively maintained database was conducted on consecutive patients diagnosed with mucormycosis undergoing immediate reconstruction utilizing our "Mucormycosis Management Protocol." All patients included in this study underwent reconstruction after recovering from COVID-19. Wide local excision was performed in all cases removing all suspected and edematous tissue. Reconstruction was done primarily after clear margins were achieved on clinical assessment under a cover of injectable liposomal amphotericin B. Results Fourteen patients were included. The average age was 43.6 years and follow-up was 24.3 days. Thirteen patients had been admitted for inpatient care of COVID-19. Steroid therapy was implemented for 2 weeks in 11 patients and for 3 weeks in 3 patients. Eight patients (57.1%) had a maxillectomy and mucosal lining resection with/without skin excision, and six patients (42.8%) underwent maxillectomy and wide tissue excision (maxillectomy and partial zygomatic resection, orbital exenteration, orbital floor resection, nose debridement, or skull base debridement). Anterolateral thigh (ALT) flaps were used to cover defects in all patients. All flaps survived. No major or minor complications occurred. No recurrence of mucormycosis was noted. Conclusion The approach presented in this study indicates that immediate reconstruction is safe and reliable in cases when appropriate tissue resection is accomplished. Further studies are required to verify the external validity of these findings.

• Molecules and Cells
• /
• v.45 no.5
• /
• pp.306-316
• /
• 2022

Chronic stress contributes to the risk of developing depression; the habenula, a nucleus in epithalamus, is associated with many neuropsychiatric disorders. Using genome-wide gene expression analysis, we analyzed the transcriptome of the habenula in rats exposed to chronic restraint stress for 14 days. We identified 379 differentially expressed genes (DEGs) that were affected by chronic stress. These genes were enriched in neuroactive ligand-receptor interaction, the cAMP (cyclic adenosine monophosphate) signaling pathway, circadian entrainment, and synaptic signaling from the Kyoto Encyclopedia of Genes and Genomes pathway analysis and responded to corticosteroids, positive regulation of lipid transport, anterograde trans-synaptic signaling, and chemical synapse transmission from the Gene Ontology analysis. Based on protein-protein interaction network analysis of the DEGs, we identified neuroactive ligand-receptor interactions, circadian entrainment, and cholinergic synapse-related subclusters. Additionally, cell type and habenular regional expression of DEGs, evaluated using a recently published single-cell RNA sequencing study (GSE137478), strongly suggest that DEGs related to neuroactive ligand-receptor interaction and trans-synaptic signaling are highly enriched in medial habenular neurons. Taken together, our findings provide a valuable set of molecular targets that may play important roles in mediating the habenular response to stress and the onset of chronic stress-induced depressive behaviors.

• The Journal of the Society of Stroke on Korean Medicine
• /
• v.23 no.1
• /
• pp.1-12
• /
• 2022

Persistent hiccups persist for more than 48 hours. Those can often occur in cancer patients after chemotherapy or high dose of corticosteroids. A 52-year-old male patient undergoing Non-small cell lung cancer(NSCLC), recently suffered presistent hiccups and dyspnea. He was treated with herbal medicine for 56days and acupuncture for 9days. No side effects were observed during treatment. The severity of hiccups was measured in every hospital visit and psychometric symptoms were evaluated periodically through the Edmonton Symptom Assessment System(ESAS). The severity of hiccups and psychometric symptoms were alleviated and the effect persisted during the treatment. The patient took no other nervous system drugs in the end of the treatment. In conclusion, Korean medicine like Hyeongbangjihwang-tang and Jeongcheonhwadamgangki-tang can be effective for patients with persistent hiccups and dyspnea who cannot use alternative drugs or treatment because of other complications.

• Korean Journal of Head & Neck Oncology
• /
• v.38 no.2
• /
• pp.23-27
• /
• 2022

Systemic lupus erythematosus(SLE) is a multisystemic disorder of autoimmune etiology. SLE can occur commonly in young women, and the early symptoms include fever, myalgia, arthralgia, weight loss, lymphadenopathy and these nonspecific symptoms develop into skin rash, splenomegaly, serositis and encephalopathy. Diagnosis of SLE requires clinical and serologic criteria, and treatment choices are hydroxyquinolone and NSAIDs for mild disease, corticosteroids and immunosuppressant for severe disease. In lupus patient, the prevalence of lymphadenopathy is 12~59%. Although lymphadenopathy is common finding in SLE, it is hard to distinguish in early phase of SLE. A 38-year-old woman visited our hospital for cervical lymphadenopathy with polyarthritis and malaise. Multiple cervical lymph nodes enlargement was found on Neck CT, and serologic laboratory test including ANA, antiphospholipid antibody, and anti-dsDNA was positive. For excluding lymphoma, PET-CT and excisional biopsy were performed. The patient finally diagnosed with SLE, and got regular follow-up without complication.

• Clinics in Shoulder and Elbow
• /
• v.26 no.2
• /
• pp.175-181
• /
• 2023

Background: Acromioclavicular (AC) osteoarthritis (OA) is a frequent pathology of the shoulder in elderly patients. Drug injection plays an important role in treatment of AC OA. Literature has demonstrated excellent short-term results regarding shoulder function and pain. However, mid- to long-term results are lacking. The aim of this study was to assess the efficacy of a single intra-articular AC injection in patients with AC OA and to identify predictive factors for success. Methods: A retrospective study was performed to analyze success rate, shoulder function, and pain perception after a single intra-articular injection in patients with AC OA. Success was defined as the absence of reinterventions such as additional injection or surgery. Outcome measures were 1-year success rate and clinical outcome scores of Numeric Rating Scale (NRS) for pain, Oxford Shoulder Score, and Subjective Shoulder Value. Results: Ninety-eight patients participated in this study. At a median final follow-up of 0.8 years (interquartile range, 0-6), 57 of these patients (58%) had undergone a reintervention. The 1-year success rate was 47% (95% confidence interval, 37%-57%), with NRS at rest as the sole factor significantly associated with success. Thirty patients not requiring reintervention reported significant improvement from baseline for all reported outcome measures at final follow-up. Conclusions: AC injections offer a 1-year success rate of 47%. The AC injection produces good mid- to long-term clinical outcomes regarding shoulder function, quality of life, and pain perception in one-third of patients. Further research is essential to analyze mid- to long-term outcomes of AC injections.

• The Journal of Internal Korean Medicine
• /
• v.44 no.3
• /
• pp.455-465
• /
• 2023

Inflammatory bowel disease (IBD) is defined as a chronic inflammatory-mediated disease that causes ulceration and inflammation in the gastrointestinal tract. Among most patients, the course of chronic inflammation repeatedly shows intermittent exacerbations and alternating remissions. However, despite the various therapeutic options to relieve symptoms, such as corticosteroids, TNF-α inhibitors, and antibiotic drugs, there is no known cure for IBD. Nonetheless, previous research has revealed that the autonomic nervous system is involved in the pathophysiology of IBD. In this study, we reviewed clinical trials confirming the therapeutic effect of vagus nerve stimulation (VNS) on IBD in vivo. We searched in vivo and human studies on Pubmed using keywords combined with "vagus nerve stimulation", "VNS", and "inflammatory bowel disease". All studies included in this review reported that direct VNS is effective in relieving symptoms of IBD and has no severe adverse effects. The most frequently stimulated site was the unilateral cervical vagus nerve area, and parameters for stimulation were set as 5-20 Hz. Based on the results, we aim to summarize the evidence for the efficacy of VNS on IBD and suggest the possibility of auricular electroacupuncture treatment as a therapeutic option for IBD.

• Clinical Pain
• /
• v.18 no.2
• /
• pp.76-81
• /
• 2019

Objective: To examine (1) the degree of reduction of passive range of motion (PROM) on the affected side compared to that on the unaffected side and (2) the degree of increase in PROM following intra-articular corticosteroid injection (IACI) in patients with frozen shoulder. Method: The medical records of 120 patients with frozen shoulder were retrospectively reviewed. PROM of the unaffected and affected shoulder (flexion, extension, abduction, internal rotation, external rotation) was compared, and changes in PROM of the affected shoulder after a single IACI (triamcinolone 20 mg) were evaluated after 12 weeks. Results: At the time of diagnosis, PROM of the affected shoulder was most limited in external rotation, followed by internal rotation, abduction, extension, and flexion, compared to that of the unaffected shoulder. Compared to before IACI, PROM of external rotation demonstrated the greatest increase compared to all the other movements after IACI. Conclusion: Limitation in PROM of the frozen shoulder at the time of diagnosis was greatest for external rotation. Moreover, external rotation experienced the greatest improvement after IACI. Our findings should help to further clarify the clinical characteristics of frozen shoulder, aid in its diagnosis, and allow the prediction of the effects of IACI.

• The Journal of Pediatrics of Korean Medicine
• /
• v.37 no.4
• /
• pp.70-90
• /
• 2023

Objective This study analyzed randomized clinical trials (RCTs) on pediatric asthma using traditional Chinese medicine (TCM) to determine its efficacy and safety. Methods We searched electronic databases in English, Chinese, Japanese, and Korean and evaluated 35 articles published up to December 28, 2022. Based on data from the literature, we analyzed treatments, results, composition of herbal medicine, frequency of medicinal herbs, and decoction. Results TCM for pediatric asthma was compared to supportive therapy, inhaled corticosteroids, and standardized treatments. Of the 35 studies, 32 showed that TCM treatments were effective in alleviating asthma symptoms. Furthermore, TCM treatment was considered safe compared to common asthma treatments. Among the TCM treatments for pediatric asthma, the most frequent decoctions were Gamisaganmahwangtang (加味射干麻黃湯) and Saganmahwangtang (射干麻黃湯). Ephedra Herba (麻黄), Armeniacae Semen (杏仁), Asiasari Radix et Rhizoma (細辛), Belamcandae Rhizoma (射干) were herbs that were frequently used for asthma in TCM decoctions. Conclusion This review showed that TCM is effective in treating pediatric asthma. More clinical RCTs are needed to confirm the efficacy and safety of TCM treatment.

• Journal of the Korean Society of Radiology
• /
• v.81 no.6
• /
• pp.1486-1491
• /
• 2020

Kikuchi disease is a type of benign, self-limiting necrotizing lymphadenitis that occurs most commonly in young women and usually manifests as palpable cervical lymph nodes and fever. Patients with an unusual location of lymph node involvement can be misdiagnosed with malignant disease. Here, we report a case of Kikuchi disease in a 15-year-old girl presenting with persistent fever for 2 weeks. Imaging studies, including ultrasonography, CT, and ¹⁸F-fluorodeoxyglucose PET/CT, revealed splenomegaly and enlarged lymph nodes in the neck, axilla, abdomen, retroperitoneum, and inguinal region. Laparoscopic excision of the celiac lymph nodes confirmed histiocytic necrotizing lymphadenitis, also known as Kikuchi disease. Conservative treatment with corticosteroids improved the patient's condition.