• 대한의용생체공학회:의공학회지
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• 제42권3호
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• pp.71-79
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• 2021

Currently, the naked eyes-based diagnosis of bone metastases on CT images relies on qualitative assessment. For this reason, there is a great need for a state-of-the-art approach that can assess and follow-up the bone metastases with quantitative biomarker. Radiomics can be used as a biomarker for objective lesion assessment by extracting quantitative numerical values from digital medical images. In this study, therefore, we evaluated the clinical applicability of non-invasive and objective bone metastases computer-aided diagnosis using radiomics-based biomarkers in CT. We employed a total of 21 approaches consist of three-classifiers and seven-feature selection methods to predict bone metastases and select biomarkers. We extracted three-dimensional features from the CT that three groups consisted of osteoblastic, osteolytic, and normal-healthy vertebral bodies. For evaluation, we compared the prediction results of the classifiers with the medical staff's diagnosis results. As a result of the three-class-classification performance evaluation, we demonstrated that the combination of the random forest classifier and the sequential backward selection feature selection approach reached AUC of 0.74 on average. Moreover, we confirmed that 90-percentile, kurtosis, and energy were the features that contributed high in the classification of bone metastases in this approach. We expect that selected quantitative features will be helpful as biomarkers in improving the patient's survival and quality of life.

• The Korean Journal of Pain
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• 제34권1호
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• pp.106-113
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• 2021

Background: We aimed to investigate the analgesic efficacy of an erector spinae plane block (ESPB) in immediate breast reconstruction (IBR) with a tissue expander. Methods: Adult women undergoing IBR with a tissue expander after mastectomy were randomly assigned to either intravenous patient-controlled analgesia (IV-PCA) alone (group P) or IV-PCA plus ESPB (group E). The primary outcome was the total amount of opioid consumption during 24 hours postoperatively between the two groups. Secondary outcomes were patient satisfaction, pain score at rest and on shoulder movement using numerical rating scale, incidences of postoperative nausea and vomiting (PONV), and a short form of the brief pain inventory (BPI-SF) at 3 and 6 months after surgery between the groups. Results: Fifty eight patients completed the study. At 24 hours postoperatively, total opioid consumption was significantly less in group E than in group P (285.0 ± 92.0, 95% confidence interval [CI]: 250.1 to 320.0 vs. 223.2 ± 83.4, 95% CI: 191.5 to 254.9, P = 0.005). Intraoperative and cumulative PCA fentanyl consumption at 3, 6, 9, and 24 hours were also less in group E than in group P (P = 0.004, P = 0.048, P = 0.020, P = 0.036, and P < 0.001, respectively). Patient satisfaction was higher in group E (6.9 ± 1.8 vs. 7.8 ± 1.4, P = 0.042). The incidences of PONV was similar. Conclusions: The ESPB decreased postoperative opioid consumption and increased patient satisfaction without significant complications after IBR with a tissue expander after mastectomy.

• The Korean Journal of Pain
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• 제34권2호
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• pp.210-216
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• 2021

Background: Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The treatment of PHN remains a challenge for clinical pain management. Despite the effectiveness of anticonvulsants, antidepressants, and lidocaine patches in reducing PHN, many patients still face intractable pain disorders. In this randomized controlled study, we evaluated whether hydromorphone through intravenous patient-controlled analgesia (IV PCA) was effective in relieving PHN. Methods: Patients with PHN were randomly divided into two groups, one group received oral pregabalin with IV normal saline, another group received oral pregabalin with additional IV PCA hydromorphone for two weeks. Efficacy was evaluated at 1, 4, and 12 weeks after the end of the treatments. Results: Two hundred and one patients were followed up for 12 weeks. After treatment, numerical rating scale (NRS) score of patients in the hydromorphone group was significantly lower than that of the control group, and the difference of NRS scores between the two groups was statistically significant at 4 and 12 weeks after treatment. The frequency of breakthrough pain in the hydromorphone group was significantly lower than that in the control group 1 and 4 weeks after treatment. After treatment, the quality of sleep in the hydromorphone group was significantly improved compared with the control group. The most common adverse reactions in the hydromorphone group were dizziness and nausea, with no significant respiratory depression. Conclusions: IV PCA hydromorphone combined with oral pregabalin provides superior pain relief in patients with PHN, which is worthy of clinical application and promotion.

• 한국환경보건학회지
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• 제46권6호
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• pp.636-645
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• 2020

Objectives: This study was performed to find phytoncide (monoterpene) emission characteristics and weather factors for application in prediction modeling for phytoncide weather services. Methods: From 2017 to 2019, one coniferous forest and one deciduous forest were selected to investigate the monthly emission characteristics and identify the correlation with weather factors. Research items were analyzed for 11 species known to be emitting the most monoterpenes. Results: Phytoncide (monoterpene) began to increase in April when trees were activated and continued to be released until November. The concentration range of monoterpene in deciduous forests was 0.0 to 427.4 ng/S㎥ and coniferous forests was 0.0 to 1,776.8 ng/S㎥. Phytoncide emission concentrations in deciduous forests were 20 to 90 percent of those in coniferous forests, and averaged 39 percent overall. The correlation between monoterpene and temperature was very close, with 0.835 for the broadleaf forest and 0.875 for the coniferous forest. Monoterpene and humidity were found to be 0.731 for the broadleaf forest and 0.681 for the coniferous forest, while wind speed showed a negative correlation of -0.482 and -0.424, respectively. Regression of temperature with phytoncide showed that the coefficient of determination (r2) was highly correlated with 0.75 for the broadleaf forest and 0.80 for the coniferous forest. Not only is phytoncide concentration affected by temperature, humidity, and wind speed, but also rainfall over the preceeding one to three days. Nearby rainfall on the day of sampling was found to have a direct effect on the physiological activities of the trees. Conclusions: Overall, if the values of monoterpene and temperature, humidity, and wind speed are used as basic factors, and rainfall from one to three days previous is replaced with complementary values, it is believed that the numerical analysis and modeling of daily and monthly phytoncide will be possible.

• Tuberculosis and Respiratory Diseases
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• 제84권2호
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• pp.96-104
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• 2021

Background: Many chronic obstructive pulmonary disease (COPD) patients receiving monotherapy continue to experience symptoms, exacerbations and poor quality of life. This study aimed to assess the efficacy and safety of direct switch from once-daily tiotropium (TIO) 18 ㎍ to indacaterol/glycopyrronium (IND/GLY) 110/50 ㎍ once daily in COPD patients in Korea. Methods: This was a randomized, open-label, parallel group, 12-week trial in mild-to-moderate COPD patients who received TIO 18 ㎍ once daily for ≥12 weeks prior to study initiation. Patients aged ≥40 years, with predicted post-bronchodilator forced expiratory volume in 1 second (FEV₁) ≥50%, post-bronchodilator FEV₁/forced vital capacity <0.7 and smoking history of ≥10 pack-years were included. Eligible patients were randomized in a 1:1 ratio to either IND/GLY or TIO. The primary objective was to demonstrate superiority of IND/GLY over TIO in pre-dose trough FEV₁ at week 12. Secondary endpoints included transition dyspnea index (TDI) focal score, COPD assessment test (CAT) total score, and rescue medication use following the 12-week treatment, and safety assessment. Results: Of the 442 patients screened, 379 were randomized and 347 completed the study. IND/GLY demonstrated superiority in pre-dose trough FEV₁ versus TIO at week 12 (least squares mean treatment difference [Δ], 50 mL; p=0.013). Also, numerical improvements were observed with IND/GLY in the TDI focal score (Δ, 0.31), CAT total score (Δ, -0.81), and rescue medication use (Δ, -0.09 puffs/day). Both treatments were well tolerated by patients. Conclusion: A direct switch from TIO to IND/GLY provided improvements in lung function and other patient-reported outcomes with an acceptable safety profile in patients with mild-to-moderate airflow limitation.

• 한국지하수토양환경학회지:지하수토양환경
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• 제27권spc호
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• pp.99-112
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• 2022

From early 2000, many researchers in the groundwater and soil environment remediation project tried to calculate the pollution level and pollution remediation cost and reflect it in the design. In addition, by identifying the movement characteristics of oil pollutants in the underground environment, many researchers tried to derive design factors necessary for pollution purification. However, although the test should be conducted in an area contaminated with oil, the toxicity and risk are too great for testing by deliberately leaking pollutants that are harmful to the human body. And as oil-contaminated areas are promoted by military units such as returned US military bases, there is a limit to access by the general public. In addition, since the indoor simulation test and the field application test have been carried out separately from each other, it was difficult to compare and review various simulation tests Therefore, in this study, PITT (Partitioning Interwell Tracer Test) and analysis methods were specifically presented through actual tests so that field workers could easily use them with the help of the military base and the Korea Rural Community Corporation Soil Environment Restoration Team. However, in order to directly reflect the distribution tracer test results in the pollution remediation design, it is necessary to reduce the analysis errors by comparing the analysis results of the existing soil pollution survey, physical exploration, and numerical modeling. In addition, it is judged to be cautious in the analysis because errors can easily occur due to various factors such as the type of oil at the polluted site, the hydraulic conductivity of the aquifer, and the skill of the researcher.

• 한방안이비인후피부과학회지
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• 제35권2호
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• pp.95-104
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• 2022

Objectives : This study is to report a case of otitis media with effusion accompanied by atopic dermatitis improved by Korean medicine monotherapy. Methods : A 31-year-old woman patient visited our clinic for aural fullness, hearing loss, and tinnitus of the left ear on August 14th, 2021. She also had abdominal pain, diarrhea, and general weakness because of side effects of antibiotics. Besides, she had nasal congestion, rhinorrhea, and dry skin. Through otoscopy, her tympanum was fully filled with yellow effusion. She only took Korean medicine therapy including acupuncture and herbal medicine weekly. The treatment continued for about 4 months(total 14 visits) until December 4th, 2021. Otoscopy, numerical rating scale(NRS), scoring atopic dermatitis(SCORAD) index were used to assess the symptoms. Results : On August 30, 2021, her intestinal symptoms improved. The left tympanum was recovered to normal condition as the treatment continued. The effusion disappeared on October 16th, 2021. On November 6th, 2021, peritympanic blood congestion also almost alleviated. Subjective symptoms including aural fullness, hearing loss, and tinnitus disappeared on October 16, 2021. Nasal symptoms and dry skin also improved. The SCORAD index dropped from 15 to 4. Conclusions : These results suggests that otitis media with effusion can be sufficiently managed by Korean medicine therapy. Further, active application of Korean medicine therapy to common otolaryngological diseases is necessary.

• 한방재활의학과학회지
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• 제32권2호
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• pp.123-138
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• 2022

Objectives This study was conducted to evaluate the clinical efficacy and safety of the chuna combination treatment for patients who complain of functional impairment and pain even 3 months after total knee arthroplasty. Methods 24 patients who had 3 months of surgery and who had knee joint pain with a score of 4 or higher on the numerical rating scale (NRS) for more than a week were selected as subjects. The test group received usual care and Chuna treatment and the control group received the administration of drugs as usual care. And then the clinical efficacy and safety were compared and evaluated. Follow-up was performed 1 month after the end of treatment. Results As a result of the analysis, it was confirmed that the primary parameter Korean Western Ontario and McMaster Universities (K-WOMAC) showed statistical significance in the amount of change in visit 2-visit 10 (V2-V10) in the pain domain and in the amount of change in visit 2-follow 1 (V2-FU1) in the functional domain and total score domain. The secondary parameter (NRS, risk of fall, and range of motion) showed a tendency to decrease in the degree of discomfort, but statistical significance could not be confirmed. Conclusions Because this study did not have enough study subjects, it is difficult to use the results as confirmatory evidence. However, it was confirmed that the 4-week Chuna treatment had a significant effect and safety in patients who underwent total knee arthroplasty. Therefore, this study is meaningful as a prior research data to prepare confirmatory evidence in the future.

• 한국자연치유학회지
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• 제9권2호
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• pp.37-45
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• 2020

목적 : 특발성파킨슨병(PD)은 운동증상(떨림, 운동 완서, 경직)과 비운동증상(통찰력과 인지 장애, 기분의 불편함, 우울증, 불안증, 후각 기능장애)이 있다. 이 연구는 호흡, 명상 및 기공 치유로 PD 비운동증상의 개선 효과를 탐색하는 것이 목적이다. 방법 : PD가 있는 대상자(11명)에게 An's-4444힐링호흡, An's관정힐링명상, An's힐링기공치유의 3단계를 1회에 80분 동안 12회 수행하고 치유 전후, 1개월 경과 후 3회 측정하여 측정치를 비교 평가하였다. 결과 : 12회 치유 후 통찰력과 인지장애에 대한 통합 파킨슨병 등급척도(UPDRSI) 수치는 69%, 우울증척도(HAMD)는 61%, 불안증(HAMA)은 64%, 후각 기능장애 냄새식별 테스트(TSI)는 82%로 각각 개선되었다. 치유 1개월 경과 후의 수치는 4개 척도 모두 차이가 없었다. 이는 치유 후 1개월 경과 후까지 효과가 유지됨을 의미한다. 결론 : An's 호흡, 명상 및 기공요법으로 PD비운동증상이 유의성 있게 개선되었다. 특히 후각기능장애 개선으로, 향기를 맡게 되어 삶의 만족도가 향상되었다. 결과는 호흡, 명상 및 기공요법이 PD의 비운동성 증상을 개선 및 치유하는 자연요법으로 가치가 있다고 판단하며, 의생명과학적 추가 연구가 필요하다.

• Journal of Korean Neurosurgical Society
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• 제65권6호
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• pp.834-840
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• 2022

Objective : C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count are inflammatory markers used to evaluate postoperative infections. Although these markers are non-specific, understanding their normal kinetics after surgery may be helpful in the early detection of postoperative infections. To compliment the recent trend of reducing the duration of antibiotic use, this retrospective study investigated the inflammatory markers of patients who had received antibiotics within 24 hours after surgery according to the Health Insurance Review & Assessment Service guidelines and compared them with those of patients who had received antibiotics for 5 days, which was proven to be non-infectious. Methods : We enrolled 74 patients, divided into two groups. Patients underwent posterior lumbar interbody fusion (PLIF) at a single institution between 2019 and 2020. Group A included 37 patients who received antibiotics within 24 hours after the PLIF procedure, and group B comprised 37 patients who had used antibiotics for 5 days. A 1 : 1 nearest-neighbor propensity-matched analysis was used. The clinical variables included age, sex, medical history, body mass index, estimated blood loss, and operation time. Laboratory data included CRP, ESR, and WBC, which were measured preoperatively and on postoperative days (POD) 1, 3, 5, and 7. Results : CRP dynamics tended to decrease after peaking on POD 3, with a similar trend in both groups. The average CRP level in group B was slightly higher than that in group A; however, the difference was not statistically significant. Multiple linear regression analysis revealed operation time, number of fused levels, and estimated blood loss as significant predictors of a greater CRP peak value (r²=0.473, p<0.001) in patients. No trend (a tendency to decrease from the peak value) could be determined for ESR and WBC count on POD 7. Conclusion : Although slight differences were observed in numerical values and kinetics, sequential changes in inflammatory markers according to the duration of antibiotic administration showed similar patterns. Knowledge of CRP kinetics allows the assessment of the degree of difference between the clinical and expected values.