• Journal of The Korean Society of Integrative Medicine
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• v.9 no.4
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• pp.271-281
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• 2021

Purpose : This study aimed to apply muscle relaxation exercise and ultrasound therapy as an effective treatment method for tension headache patients by comparatively analyzing the muscle mechanical properties, neck disorder index, and headache impact test. Method : The subjects were classified into three groups based on the intervention received: the therapeutic ultrasound (n=15, group I), placebo therapeutic ultrasound combined with the suboccipital release (n=15, group II), and therapeutic ultrasound combined with suboccipital release (n=15, group III) groups. The intragroup and intergroup differences in muscle mechanical properties, neck disability index, and headache impact test were compared and analyzed. Result : The comparison and analyses of the changes in muscle tone and post hoc analysis revealed statistically significant intragroup decreases in the suboccipitalis and upper trapezius in groups I and III. Furthermore, statistically significant intergroup differences in the upper trapezius with a greater change in group III than in group II and suboccipitalis with greater changes in group III than in groups I and II were observed. The comparison and analyses of the changes in muscle stiffness and post hoc analysis revealed statistically significant intragroup decreases in the upper trapezius in group I and suboccipitalis in group III. Moreover, statistically significant intergroup differences in both muscles with greater changes in group III than in group II for both cases were observed. The comparison and analyses of the changes in the neck disability index and post hoc analysis revealed statistically significant intragroup decreases in all three groups and statistically significant intergroup differences with greater changes in group III than in groups I and II. The comparison and analyses of the changes in the headache impact test and post hoc analysis revealed statistically significant intragroup decreases in all three groups and a statistically significant intergroup difference with greater changes in group III than in groups I and II. Conclusion : The therapeutic ultrasound and suboccipital muscle release exercise effectively increased the flexibility of the muscles around the cervical vertebrae and reduced muscle tension and stiffness in tension-type headache patients.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.4
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• pp.283-289
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• 2021

Purpose : The purpose of this study is to investigate the effect of mid frequency electrical stimulation during squat exercise on the muscle activity and muscle activity ratio of vastus medialis oblique and vastus lateralis, and to prepare scientific basic data for exercise intervention using mid frequency electrical stimulation. Methods : This study was conducted with students from University C located in Busan, and among a total of 123 subjects, 12 subjects who complained of knee joint dysfunction between 80 and 90 points using the Kujala patellofemoral score (KPS) were used. All subjects participated in the experiment for 3 days, and MVIC values were measured for normalization of muscle activity values on the first day. For the two days, participants participated in the experiment and performed squat exercise or squat exercise receiving mid-frequency electrical stimulation in random order. Measurements were taken in the squat position immediately after the squat exercise, and muscle activities of vastus medialis oblique and vastus lateralis were measured. The measured data were compared through the dependent t test, and the statistical significance level was set to .05. Results : According to the results of this study, in the case of applying mid-frequency electrical stimulation together in the ratio of vastus medialis oblique and vastus lateralis muscle activity during squat exercise, higher values were observed compared to the case of not applying mid-frequency electrical stimulation together, and statistically significant. Also, when mid-frequency electrical stimulation was applied to both vastus medialis oblique and vastus lateralis activities during the squat exercise, higher values were shown compared to the case where the mid-frequency electrical stimulation was not applied together, but there was no statistically significant difference. Conclusion : The results of this study reported that mid-frequency electrical stimulation provided to vastus medialis oblique increased the muscle activity ratio of vastus medialis oblique and vastus lateralis. Therefore, the improvement of coordination due to the enhancement of the activity of vastus medialis oblique through mid-frequency electrical stimulation will be more helpful in the treatment of patellofemoral pain syndrome patient. In addition, it is hoped that the electrical stimulation method applied to exercise will be widely used.

• Journal of Periodontal and Implant Science
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• v.51 no.3
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• pp.147-162
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• 2021

Purpose: This systematic review and meta-analysis was conducted to assess the effects of glycine powder air-polishing (GPAP) in patients during supportive periodontal therapy (SPT) compared to hand instrumentation and ultrasonic scaling. Methods: The authors searched for randomized clinical trials in 8 electronic databases for relevant studies through November 15, 2019. The eligibility criteria were as follows: population, patients with chronic periodontitis undergoing SPT; intervention and comparison, patients treated by GPAP with a standard/nozzle type jet or mechanical instrumentation; and outcomes, bleeding on probing (BOP), patient discomfort/pain (assessed by a visual analogue scale [VAS]), probing depth (PD), gingival recession (Rec), plaque index (PI), clinical attachment level (CAL), gingival epithelium score, and subgingival bacteria count. After extracting the data and assessing the risk of bias, the authors performed the meta-analysis. Results: In total, 17 studies were included in this study. The difference of means for BOP in patients who received GPAP was lower (difference of means: -8.02%; 95% confidence interval [CI], -12.10% to -3.95%; P<0.00001; I²=10%) than that in patients treated with hand instrumentation. The results of patient discomfort/pain measured by a VAS (difference of means: -1.48, 95% CI, -1.90 to -1.06; P<0.001; I²=83%) indicated that treatment with GPAP might be less painful than ultrasonic scaling. The results of PD, Rec, PI, and CAL showed that GPAP had no advantage over hand instrumentation or ultrasonic scaling. Conclusions: The findings of this study suggest that GPAP may alleviate gingival inflammation more effectively and be less painful than traditional methods, which makes it a promising alternative for dental clinical use. With regards to PD, Rec, PI, and CAL, there was insufficient evidence to support a difference among GPAP, hand instrumentation, and ultrasonic scaling. Higher-quality studies are still needed to assess the effects of GPAP.

• Pediatric Infection and Vaccine
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• v.28 no.2
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• pp.110-117
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• 2021

Toxic megacolon is a fatal complication of inflammatory or infectious bowel disease. Prognosis depends on the severity of the disease. In cases of poor prognosis, clinical outcomes range from intestinal resection to death, so early diagnosis and appropriate treatment are very important. However, the prevalence of toxic megacolon in children is very low, and in those without underlying diseases such as inflammatory bowel disease, early diagnosis may be delayed. A previously healthy 12-year-old boy presented to our hospital with lower abdomen pain, fever, and hematochezia. Despite antibiotic therapy, the symptoms worsened. On the third day, abdominal computed tomography revealed severe dilatation of the transverse colon, which indicated toxic megacolon. Stool culture was positive for Salmonella enteritidis group D, and rectal endoscopy showed no signs of inflammatory bowel disease. Ceftriaxone and intravenous methylprednisolone were administered, and the patient's condition improved without any complications. We report a case of toxic megacolon as a complication of infectious colitis caused by S. enteritidis group D, which was diagnosed using early imaging and successfully treated without surgical intervention.

• Journal of Korea Entertainment Industry Association
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• v.14 no.3
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• pp.343-352
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• 2020

The aim of this study was to investigate the relationship between level of participation in children's play, empathy ability and coping behavior in mothers of children with disabilities. The study included 94 mothers of children with disabilities and the study was conducted from May 2018 to August 2018 based on the questionnaire about the level of participation in children's play, empathy ability and coping behavior. According to the study, Mothers of children with disabilities actively participate in physical play with their children and have a higher emotional empathy compared to cognitive empathy, and have acted to actively solve the problems for their children. When children have been treated for more than 1 to 2 years, the level of participation in children's play and the coping behavior were the highest. The longer their children's treatment period, the higher the mothers' empathy. The correlation between level of participation in children's play and coping behavior were significant. And empathy and coping behavior had a strong positive linear relationship. These results suggest that there are differences in level of participation in children's play, empathy and coping behavior depending on mothers' of children with disabilities general characteristics and the higher level of mothers' of children with disabilities participation in children's play, the more empathetic they have. When individualized intervention is provided, we look forward to providing professional service that take into account the characteristics of mothers of children with disabilities.

• Journal of Biomedical Engineering Research
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• v.43 no.5
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• pp.341-352
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• 2022

Medical image segmentation is the most important task in radiation therapy. Especially, when segmenting medical images, the liver is one of the most difficult organs to segment because it has various shapes and is close to other organs. Therefore, automatic segmentation of the liver in computed tomography (CT) images is a difficult task. Since tumors also have low contrast in surrounding tissues, and the shape, location, size, and number of tumors vary from patient to patient, accurate tumor segmentation takes a long time. In this study, we propose a method algorithm for automatically segmenting the liver and tumor for this purpose. As an advantage of setting the boundaries of the tumor, the liver and tumor were automatically segmented from the CT image using the 2D CoordConv DeepLab V3+ model using the CoordConv layer. For tumors, only cropped liver images were used to improve accuracy. Additionally, to increase the segmentation accuracy, augmentation, preprocess, loss function, and hyperparameter were used to find optimal values. We compared the CoordConv DeepLab v3+ model using the CoordConv layer and the DeepLab V3+ model without the CoordConv layer to determine whether they affected the segmentation accuracy. The data sets used included 131 hepatic tumor segmentation (LiTS) challenge data sets (100 train sets, 16 validation sets, and 15 test sets). Additional learned data were tested using 15 clinical data from Seoul St. Mary's Hospital. The evaluation was compared with the study results learned with a two-dimensional deep learning-based model. Dice values without the CoordConv layer achieved 0.965 ± 0.01 for liver segmentation and 0.925 ± 0.04 for tumor segmentation using the LiTS data set. Results from the clinical data set achieved 0.927 ± 0.02 for liver division and 0.903 ± 0.05 for tumor division. The dice values using the CoordConv layer achieved 0.989 ± 0.02 for liver segmentation and 0.937 ± 0.07 for tumor segmentation using the LiTS data set. Results from the clinical data set achieved 0.944 ± 0.02 for liver division and 0.916 ± 0.18 for tumor division. The use of CoordConv layers improves the segmentation accuracy. The highest of the most recently published values were 0.960 and 0.749 for liver and tumor division, respectively. However, better performance was achieved with 0.989 and 0.937 results for liver and tumor, which would have been used with the algorithm proposed in this study. The algorithm proposed in this study can play a useful role in treatment planning by improving contouring accuracy and reducing time when segmentation evaluation of liver and tumor is performed. And accurate identification of liver anatomy in medical imaging applications, such as surgical planning, as well as radiotherapy, which can leverage the findings of this study, can help clinical evaluation of the risks and benefits of liver intervention.

• The Korean Journal of Physiology and Pharmacology
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• v.26 no.6
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• pp.541-556
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• 2022

Myocardial fibrosis is a key link in the occurrence and development of diabetic cardiomyopathy. Its etiology is complex, and the effect of drugs is not good. Cardiomyocyte apoptosis is an important cause of myocardial fibrosis. The purpose of this study was to investigate the effect of gaseous signal molecule sulfur dioxide (SO₂) on diabetic myocardial fibrosis and its internal regulatory mechanism. Masson and TUNEL staining, Western-blot, transmission electron microscopy, RT-qPCR, immunofluorescence staining, and flow cytometry were used in the study, and the interstitial collagen deposition, autophagy, apoptosis, and changes in phosphatidylinositol 3-kinase (PI3K)/AKT pathways were evaluated from in vivo and in vitro experiments. The results showed that diabetic myocardial fibrosis was accompanied by cardiomyocyte apoptosis and down-regulation of endogenous SO₂-producing enzyme aspartate aminotransferase (AAT)_1/2. However, exogenous SO₂ donors could up-regulate AAT_1/2, reduce apoptosis of cardiomyocytes induced by diabetic rats or high glucose, inhibit phosphorylation of PI3K/AKT protein, up-regulate autophagy, and reduce interstitial collagen deposition. In conclusion, the results of this study suggest that the gaseous signal molecule SO₂ can inhibit the PI3K/AKT pathway to promote cytoprotective autophagy and inhibit cardiomyocyte apoptosis to improve myocardial fibrosis in diabetic rats. The results of this study are expected to provide new targets and intervention strategies for the prevention and treatment of diabetic cardiomyopathy.

• The Journal of Internal Korean Medicine
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• v.43 no.4
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• pp.582-595
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• 2022

Objectives: To investigate the effects of acupuncture at GV20 and EX-HN1 on cerebral blood flow (CBF) velocity and cerebrovascular reactivity (CVR) in the middle cerebral arteries (MCA) and anterior cerebral arteries (ACA) and to compare the effects to acupuncture at GV20. Methods: The study was a randomized, crossover trial that included 10 healthy men aged 20 to 29 years who underwent acupuncture treatment four times with a washout period of one week. The CBF velocity and CVR were measured by transcranial Doppler sonography (TCD) on both MCAs at the first and second visits, and both ACAs at the third and fourth visits. Participants were randomly assigned to one of two groups (A and B) before the first and third visits. Group A received two phases of acupuncture intervention at a single GV20 point and a combination of GV20 and EX-HN1 acupoints. Group B received the same interventions, but in the reverse order. Results: The increase in CO₂ reactivity was significantly higher for the combination acupoints of GV20 and EX-HN1 than for the GV20 single acupoint in both MCAs (Right: 136 to 178, p=0.017; Left: 127 to 191, p=0.017) and ACAs (Right: 133 to 158, p=0.013; Left: 122 to 168, p=0.025). No significant change was noted in the corrected velocity at PETCO₂ 40 mmHg, blood pressure, or heart rate. Conclusions: The findings suggest that improvement of the CBF in the MCA and ACA after GV20 acupuncture increases when acupuncture is also performed at EX-HN1. These results clinically support the combined use of EX-HN1 and GV20 to treat disorders of MCA and ACA circulation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.3
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• pp.288-294
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• 2021

Purpose: Despite aggressive medical and nutritional management, patients with methylmalonic acidemia (MMA) often suffer from multi-organ damage. Early deceased donor liver transplantation (DDLT) has emerged as an intervention to prevent disease progression. We investigated the efficacy of living donor LT (LDLT) with a potential carrier of MMA and a small volume of graft in patients with MMA as an alternative to DDLT. Methods: Of five patients (three male, two female; median age 5.7 years; range, 1.3-13.7 years), four underwent carrier LDLT, while one underwent non-carrier auxiliary LDLT. All patients received pre- and post-LT continuous renal replacement therapy and were provided with minimal restriction diet according to serum MMA level after LT. MMA levels in the serum and urine, the incidence of metabolic crisis, and clinical findings before and after LT were compared. Results: The survival rate was 100% during 2.2 years of follow up period after LT. In all five cases, MMA titer in the serum after transplantation decreased with less restrictive diet. Metabolic crisis was not observed during the follow-up period. In addition, no patient showed progression of severe renal impairment requiring hemodialysis. Progression of delayed cognitive development was not observed. Social functioning with improved neuropsychiatric development was observed. Conclusion: This study showed that LDLT achieved improved quality of life with less restrictive diet, therefore it could be a feasible alternative option to DDLT for the treatment of patients with MMA, even with an auxiliary LT.

• Korean Journal of Schizophrenia Research
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• v.23 no.1
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• pp.1-7
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• 2020

Objectives: This study aimed to identify factors affecting the duration of untreated psychosis (DUP) in patients with schizophrenia spectrum disorder. Methods: Six-hundred patients with schizophrenia spectrum disorder were recruited from mental health welfare centers in Gwangju Metropolitan City and Gyeonggi-do. Subjects were categorized into two groups according to median DUP. Demographic and clinical characteristics were compared between the two groups. Results: The mean DUP was 80.8 weeks, and the median DUP was 15.9 weeks. Patients with Medicaid, higher age, and longer duration of the schizophrenia prodrome were more likely to have a longer DUP. The DUP was shorter in patients who were consulted by family/relatives prior to treatment. Patients visiting university hospitals were more likely to have a shorter DUP compared with those visiting psychiatric clinics or small-sized mental hospitals, i.e., with less than 100 beds. A multivariate regression analysis showed that the duration of the prodrome was a factor that significantly affected DUP. Conclusion: The vulnerable group of patients with schizophrenia with a long DUP should be monitored closely. Moreover, it is necessary to develop a strategy to identify patients who have an insidious course of psychosis to reduce the DUP.