Objectives : This study reviews whether the traditional medical thought process reflected in the Traditional Chinese Medical Treatment Plan for COVID-19 is based on existing classical texts, and examine concerns over the quality of evidence that the plan is based on. Methods : First, terminology and basic formulas composing the compound formulas in the COVID-19 TCM Treatment Plan were collected. Next, their usage in existing classical texts were searched in the medical classics database. Results : Infectious diseases similar to COVID-19 were understood as external disease due to Six Qi in the texts. Basic formulas used for treatment were those applied in Shanghan and Wenbing, among which cases where such formulas were applied in infectious diseases could be found in the classics. Conclusions : The level of evidence of the Treatment Plan suggested by various specialists could be evaluated as insufficient if we consider the literature. However, if application of such a plan could be supported institutionally, it could become a starting point for evidence generation.
Kim, Kangpyo;Lee, Jeongshim;Cho, Yeona;Chung, Seung Yeun;Lee, Jason Joon Bock;Lee, Chang Geol;Cho, Jaeho
Radiation Oncology Journal
/
v.35
no.2
/
pp.163-171
/
2017
Purpose: Although stereotactic ablative body radiotherapy (SABR) is widely used therapeutic technique, predictive factors of radiation pneumonitis (RP) after SABR remain undefined. We aimed to investigate the predictive factors affecting RP in patients with primary or metastatic lung tumors who received SABR. Materials and Methods: From 2012 to 2015, we reviewed 59 patients with 72 primary or metastatic lung tumors treated with SABR, and performed analyses of clinical and dosimetric variables related to symptomatic RP. SABR was delivered as 45-60 Gy in 3-4 fractions, which were over 100 Gy in BED when the ${\alpha}/{\beta}$ value was assumed to be 10. Tumor volume and other various dose volume factors were analyzed using median value as a cutoff value. RP was graded per the Common Terminology Criteria for Adverse Events v4.03. Results: At the median follow-up period of 11 months, symptomatic RP was observed in 13 lesions (12 patients, 18.1%), including grade 2 RP in 11 lesions and grade 3 in 2 lesions. Patients with planning target volume (PTV) of ${\leq}14.35mL$ had significantly lower rates of symptomatic RP when compared to others (8.6% vs. 27%; p = 0.048). Rates of symptomatic RP in patients with internal gross tumor volume (iGTV) >4.21 mL were higher than with ${\leq}4.21mL$ (29.7% vs. 6.1%; p = 0.017). Conclusions: The incidence of symptomatic RP following treatment with SABR was acceptable with grade 2 RP being observed in most patients. iGTV over 4.21 mL and PTV of over 14.35 mL were significant predictive factors related to symptomatic RP.
Song, Si Yeon;Bae, Kyeore;Shin, Kwhang Ho;Yoo, Hwa-Seung
Journal of Pharmacopuncture
/
v.20
no.4
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pp.280-286
/
2017
Objective: This case series aims to report the efficacy and the safety of using snake venom pharmacopuncture (SVP) for chemotherapy-induced peripheral neuropathy (CIPN). Methods: Three heterogeneous cancer (1 endometrium, 1 cervix, and 1 prostate cancer) patients were referred to the East-West Cancer Center (EWCC), Dunsan Korean Medicine Hospital of Daejeon University, from August 02, 2017, to September 15, 2017, for treatment with SVP, and they were treated with SVP 4 times, 6 times, and 8 times, respectively. During the treatment period, the efficacy of SVP therapy was assessed by using the Numerical Rating Scale (NRS) and the Common Terminology Criteria for Adverse Events (CTCAE), and the stability was evaluated by using blood tests. Following each session, all patients were examined closely for any allergenic responses or adverse effects. Results: All patients showed noticeable improvements of their NRS and CTCAE scores. Except for bleeding and bruising at the SVP injection site, no major side effects were noted. One of the patients reported mild chilling and a sore throat after receiving the second treatment; those symptoms went away after a few hours. No hematologic toxicity, hepatotoxicity, or nephrotoxicity was found on the blood test. Conclusion: The results of this research suggest positive potential benefits of using SVP for treating patients with CIPN. Also, the excellent safety results of SVP seen in this research should lead to larger clinical trials aimed at developing SVP into a potential intervention for managing patients with the symptoms of CIPN.
Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implementation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on 'medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,' 'herb combination information' and 'search engine by efficacy of prescription.' The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, 'medicine information' and 'prescription analysis information through basic constitution analyses.' The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.
Objectives : To observe the mitigating effects of a Traditional Korean Medicine treatment program, called Wheel Balanced Cancer Therapy (WBCT), with Adriamycin and 5-FU chemotherapy on a breast cancer patient. Methods : A 26 year old female patient diagnosed with stage IIb breast cancer was admitted to the East-West Cancer Center (EWCC) in February of 2010. She received Adriamycin and 5-FU from February 22nd, to July 20th, 2010 followed by WBCT consisting of herbal medicine, acupuncture, moxibustion and physiotherapy for 5 months. Her symptoms were measured by Common Terminology Criteria for Adverse Events (CTCAE) and her quality of life was measured by Eastern Cooperative Oncology Group (ECOG). Results : WBCT significantly alleviated chemotherapy-induced nausea, oral dryness, and peripheral neuropathy. Quality of life also significantly improved. Conclusions : This case study potentiates WBCT's significant efficacy in aiding breast cancer patients suffering from Adriamycin plus 5-FU chemotherapy induced adverse effects.
Park, Byoung-Sun;Kim, Eun-Ha;Lee, Sun-A;Lee, Byung-Wook
Journal of Korean Medical classics
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v.21
no.1
/
pp.79-92
/
2008
Objective The analysis method based on the herbal formula's effects is a general tool, in traditional medicine. In effective applications of herbal formula, Korean herbal medicines traditionally used the classification methods based on the curative effects through the various compositions of herbal formulas. However' the effects of herbal formulas were not filed systemically in ancient literatures, and the standards to confirm their effects are not clear. Thus, it is not easy to classify herbal formulas according to the curative effects. Furthermore, there are no standards to estimate the effects of prescriptions frequently directed in clinic. In this study, we aimed to provide the methodology of classifying the curative effects of herbal formulas by calculating the combination of the effect of each compositional herb through the DB systems. Results : By comparing effects of herbal formula with those of compositional herbs, we found that about 25-50% of the herbal effects were included in herbal formula's effects. These results showed that the prospective estimation of herbal formula's effects may be possible through the DB systems filing herbal effects. To enhance the accuracy in explaining the herbal formula's effect, more studies are needed by giving prominence to major effects and by subtracting minor effects.
Journal of Physiology & Pathology in Korean Medicine
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v.28
no.4
/
pp.460-463
/
2014
Chemotherapy-induced peripheral neuropathy (CIPN) which is one of the common chemotherapy related toxicity poses a significant clinical challenge. Here we conducted a prospective pilot study to evaluate the efficacy of acupuncture on CIPN. Patients with CIPN were administered acupuncture procedure with continuation of previous conventional medication. Acupuncture procedures were conducted three times per week for 3 weeks. We assessed patients with Common Terminology Criteria for Adverse Events (CTCAE) v4.0, Visual Analog Scale (VAS), Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Neurotoxicity (FACT/GOG-Ntx) at the time of baseline and every week after the acupuncture procedures. Total 5 patients were included and treated with acupuncture. CTCAE grades were the same of 2 in all patients. VAS mean value changed from 5.2 to 3.2, and FACT/GOG-Ntx total score that suggests the higher relates to better quality of life changed from 93.3 to 110 as mean value at the end of the 3rd week, though this index difference did not show any statistically significant difference. This pilot study suggests that acupuncture procedure may have a role for CIPN treatment. Launching a more larger and properly controlled study will be required to ascertain the efficacy of acupuncture.
John M. Tarazi;Matthew J. Partan;Alton Daley;Brandon Klein;Luke Bartlett;Randy M. Cohn
Clinics in Shoulder and Elbow
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v.26
no.3
/
pp.252-259
/
2023
Background: The purpose of this study was to identify demographics and risk factors associated with unplanned 30-day readmission and reoperation following open procedures for shoulder instability and examine recent trends in open shoulder instability procedures. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried using current procedural terminology (CPT) codes 23455, 23460, and 23462 to find patients who underwent shoulder instability surgery from 2015 to 2019. Independent sample Student t-tests and chi-square tests were used in univariate analyses to identify demographic, lifestyle, and perioperative variables related to 30-day readmission following repair for shoulder instability. Multivariate logistic regression modeling was subsequently performed. Results: In total, 1,942 cases of open surgical procedures for shoulder instability were identified. Within our study sample, 1.27% of patients were readmitted within 30 days of surgery, and 0.85% required reoperation. Multivariate logistic regression modeling confirmed that the following patient variables were associated with a statistically significant increase in the odds of readmission: open anterior bone block/Latarjet-Bristow procedure, being a current smoker, and a long hospital stay (all P<0.05). Multivariate logistic regression modeling confirmed statistically significant increased odds of reoperation with an open anterior bone block or Latarjet-Bristow procedure (P<0.05). Conclusions: Unplanned 30-day readmission and reoperation after open shoulder instability surgery is infrequent. Patients who are current smokers, have an open anterior bone block or Latarjet-Bristow procedure, or a longer than average hospital stay have higher odds of readmission than others. Patients who undergo an open anterior bone block or Latarjet-Bristow procedure have higher odds of reoperation than those who undergo an open soft-tissue procedure. Level of evidence: III.
Purpose: To evaluate the rate of tumor response, local control, and treatment-related complications after hypofractionated radiotherapy for recurrent hepatocelluar carcinoma (HCC) less than 5 cm in size. Materials and Methods: Among the HCC patients who were treated by radiotherapy (RT) between 2006 and 2007 after the failure of previous treatment, a total of 12 patients were treated with hypofractionated RT. The criteria for hypofractionated RT was as follows: 1) HCC less than 5 cm, 2) HCC not adjacent to a critical organ, 3) HCC without portal vein tumor thrombosis, and 4) less than 15% of normal liver volume that irradiated 50% of the prescribed dose. Hypofractionated RT was performed with 50 Gy delivered in 10 fractions, at a rate of 5 fractions per week. The evaluation of tumor response was determined by CT scans performed at 3 months after the cessation of RT, followed by the evaluation of toxicity by Common Terminology Criteria for Adverse Events version 3.0. The median follow-up period after radiotherapy was 18 months. Results: A complete response (CR) was achieved in 5 of 12 lesions (41.7%) at CT performed at 3 months after the cessation, whereas the overall complete response was observed in 7 of 12 cases (58.3%). In-field local control rate was sustained in 83.3% of patients. All patients developed intra-hepatic metastases except for 2 patients. The overall survival rate was 90.0% at 1 year and 67.5% at 2 years, respectively. Three patients developed Grade 1 nausea during RT and 1 patient showed a progression of ascites after RT. There was no grade 3 or greater treatment-related toxicities. Conclusion: Hypofractionated RT for small-sized HCC as a salvage therapy showed a 58.3% CR rate and 83.3% of local control. Fifty Gy administered in 10 fractions of partial liver irradiation is considered as a tolerable dose that does not cause severe complications.
Objective : This study was conducted to infer the effect of superficies-resolveing herbs by analyzing effect terms which have extracted and refined, based on four temperatures and five tastes. Method : Firstly, temperatures, tastes and effect terms were extracted from the 27 kinds of superficies-resolving herbs written in Herbology. Then, each effect terms was divided into single meaning term and refined as typical term, using the inclusive effect terms I established. After that, herbs were grouped by tastes and found the effect terms which are mentioned most frequently. And it could be supposed to be classified into each herb's new effects based on the relationship between properties and those effect terms. It is also inferred into new tastes from some herbs by analysing the representative effects group of each taste and finding which other tastes can be related to each herb's effect. Result & Conclusion : All the superficies-resolving herbs can have wind-dispelling effect and superficies-resolving effect, except Bulpleuri Radix. This herb is able to has just the wind-dispelling effect. And it's more appropriate to categorize Bulpleuri Radix to heat-clearing herb group than superficies-resolving herb group, considering its several, distinctly cold characteristics. Some effects are concentrated to wind-cold-dispersing herb group and others to wind-heat-dispersing herb group. Each tastes has its own representative effect group. And, according to its tastes' representative effect, some of herbs are reasonable to get new effect term. With not so feasible reason, 4 kinds of herbs are supposed to contain all of hot, bitter, and sweet tastes. Also It's needed to study much deeper whether Perillae Herba, Zingiberis Rhizoma Crudus and Elsholtziae Herba are belong to superficies-resolving herb group or to interior-warming or damp-dissolving aromatic herb group.
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