Objectives The aim of this study was to examine significant improvement of gait ataxia, vertigo and tremor after treatment with Sipyimigwanjung-tang, Hyangsayangwi-tang in a Soeumin Greater Yin Symptomatology patient Diagnosed as Cerebellar ataxia. Methods The patient was diagnosed with Soeumin Greater Yin Symptomatology and treated with Soeumin's constitutional medications and acupuncture. The primary outcome measures for this study were the Unified Multiple System Atrophy Rating Scale(UMSARS) and Cerebellar function test to assess the overall function of patient. Secondary outcome assessment included Global Assessment Scale(GAS), change of patient's sleep, stool and digestion. Results The symptoms of gait ataxia, vertigo and tremor decreased from GAS 100 to GAS 0~40 after treatment, and the UMSARS score decreased in Part I, II. Conclusions This case showed that Sasang Constitutional medicine treatment can be effective treatment method for cerebellar ataxia. We consider that consistent treatment can contribute to improve the patient's quality of life.
Objective : Very large (20-25 mm) and giant (${\geq}25mm$) intracranial aneurysms have an extremely poor natural course, and treatment of these aneurysms remains a challenge for endovascular and surgical strategies. This study was undertaken to describe our experiences of endosaccular treatment of very large and giant intracranial aneurysms with parent artery preservation. Methods : From January 2005 to October 2016, twenty-four very large or giant aneurysms in 24 patients were treated by endosaccular coil embolization with parent artery preservation. Nine (37.5%) aneurysms were ruptured and 15 were unruptured, and of these 15, 11 were symptomatic cases and 4 were incidentally discovered. The cohort comprised 17 women and 7 men of mean age 58.5 years (range, 26-82). Mean aneurysm size was 26.0 mm (range, 20-39) and 13 of the 24 aneurysms were giant. Results : Immediate angiographic results were complete occlusion in nine (37.5%) cases, remnant neck in six (25.0%), and remnant sac in nine (37.5%). Overall procedural related morbidity and mortality rates were 12.5% and 4.2%, respectively. Angiographic follow-up was available in 16 patients (66.7%). Mean and median follow-up periods were 27.2 (range, 2-77) and 10.5 months, respectively. In 12 cases (12/16, 75%) stable occlusion was achieved, four cases (4/16, 25%) had recanalized, and two of these were retreated with additional coiling. At clinical follow-up of the nine ruptured cases, three patients (33.3%) achieved a good clinical outcome (Glasgow outcome scale [GOS] score of 4 or 5), two (22.2%) a poor outcome (GOS score of 2 or 3), and four patients (44.4%) expired (GOS 1). On the other hand, of the 15 unruptured cases, 13 patients (86.7%) achieved a good clinical outcome (GOS 4 or 5), one patient a poor outcome (GOS score of 2 or 3), and one patient expired (GOS 1). Conclusion : The present study shows endosaccular treatment of very large or giant intracranial aneurysms with parent artery preservation is both feasible and effective with acceptable morbidity and mortality.
Purpose Since human brains catch images faster than texts or numbers, infographics has been widely used in business in the form of "information dashboard" to enhance the efficiency of decision-making. Groupware, however, has neglected the adoption and use of infographics, in particular, in the idea generation process. Given that an overall performance of groupware-based idea generation is no better than that of the (paper-and-pencil-based) Nominal Group Technique, Jung et al. (2010) adopted the notion of infographics in the form of performance feedback to solve the productivity paradox. With the consistent results, which demonstrate beneficial effects of infographics on performance enhancement, an interesting observation that groups with the bar chart treatment performed better than groups with the dot chart treatment was made. The main purpose of this study was to find if there were a performance consistency between the outcomes from the previous study and the outcomes from the current study. Design/methodology/approach In experiment 1, we employed the same system used in the previous study (i.e., Jung et al., 2010). As individuals' contributions accumulated, the mechanism visually displayed individuals' performances two-dimensionally in the form of a bar chart or a dot chart. Then, we compared the performance outcomes from this study to the outcomes from previous study (i.e., Jung et al., 2010). In experiment 2, we modified the performance graph to test the effect of "playfulness" on performance by converting dots to car images. Then, we compared the performance outcome from experiment 2 to the outcomes from experiment 1. Findings Just like our interesting (and unexpected) finding in Jung et al.'s study (2010), the outcome confirmed a consistent superior performance of a bar chart. This implies that a bar chart is a better choice when stimulating performance with a visual aid in the context of groupware-based idea generation. Although a bar chart was criticized in a way that errors of length-area judgments are 40 ~ 250% greater than those of positional judgments along a common scale, such illusion turned out to be facilitating upward performance comparison better. Regarding Experiment 2, the outcome showed that the revised-dot graph is as good as the bar graph in terms of quantity and quality score of ideas. We attribute the performance enhancement of the resized-dot to the interaction between the motivational characteristic and the situational characteristic of playfulness because individuals in the revised-dot graph treatment performed better than individuals in the dot graph treatment. Given the order of performance (Bar >= Revised Dot > Dot) that the revised-dot treatment performed the same as (or lower than) the bar treatment, an additional research is warranted to reach to a consistent outcome.
Park, In-bum;Kim, Sang-woo;Lee, Chae-woo;Kim, Hong-gi;Heo, Sung-woong;Youn, Hyoun-min;Jang, Kyung-jeon;Ahn, Chang-beohm
Journal of Acupuncture Research
/
v.21
no.5
/
pp.191-203
/
2004
Objectives : The purpose of this study is comparison of clinical treatment outcome between oriental medicine group and oriental-western medicine group about Bell's palsy. Methods : We measured the facial palsy changes of the patients who were admitted for Bell's palsy in the Oriental Medical hospital of Dong-eui medical center from 07-01-2003 to 07-12-2004. Bell's palsy patients were divided into two groups. One group(A group) was treated by Oriental medicine treatment. The other group(B group) was treated by Oriental-Western medicine treatment. The effects of these treatment was evaluated by Yanagihara's unweighted grading system. Results : B group was marked more higher than A group in treatment outcome. We discovered that it is significant differences between two groups after 1 week and after 2 week in treatment stage. Conclusion : These results provided that B group was more effective than A group in treatment of Bell's palsy. For clearly comparing the effect of Oriental medicine treatment and Oriental-Western medicine treatment on Bell's palsy, more numbers of sample and longer duration of treatment are needed.
Objective : Acute cerebral infarction is often accompanied by transtentorial herniation which can be fatal. The aim of this study is to determine the timing of surgical intervention and prognostic factors in patients who present with acute cerebral infarction. Methods : We reviewed retrospectively 23 patients with acute cerebral infarction, who received decompressive craniectomy or conservative treatment from January 2002 to December 2004. We divided patients into two groups according to the treatment modalities [Group 1 : conservative treatment, Group 2 : decompressive craniectomy]. In all patients, the outcome was quantified with Glasgow Outcome Scale and Barthel Index. Results : Of the 23 patients, 11 underwent decompressive craniectomy. With decompressive craniectomy at the time of loss of pupillary light reflex, we were able to prevent death secondary to severe brain edema in all cases. Preoperative Glasgow Coma Scale and loss of pupillary light reflex were significant to the clinical outcome statistically. With conservative treatment, 9 of the 12 patients died secondary to transtentorial herniation. The clinical outcomes of remaining 3 patients were poor. Conclusion : This study confirms the value of life-saving procedure of decompressive craniectomy after acute cerebral infarction. We propose that the loss of pupillary light reflex should be considered one of the most important factors to determine the timing of the decompressive craniectomy.
Unlike randomized trial, statistical strategies for inferring the unbiased causal relationship are required in the observational studies. The matching with the propensity score is one of the most popular methods to control the confounders in order to evaluate the effect of the treatment on the outcome variable. Recently, new methods for the causal inference in latent class analysis (LCA) have been proposed to estimate the average causal effect (ACE) of the treatment on the latent discrete variable. They have focused on the application study for the real dataset to estimate the ACE in LCA. In practice, however, the true values of the ACE are not known, and it is difficult to evaluate the performance of the estimated the ACE. In this study, we propose a method to generate a synthetic data using the propensity score in the framework of LCA, where treatment and outcome variables are latent. We then propose a new method for estimating the ACE in LCA and evaluate its performance via simulation studies. Furthermore we present an empirical analysis based on data form the 'National Longitudinal Study of Adolescents Health,' where puberty as a latent treatment and substance use as a latent outcome variable.
Lee, Jong Moo;Ahn, Jae Sung;Kim, Jeong Hoon;Kim, Chang Jin;Kwon, Yang;Lee, Jung Kyo;Kwun, Byung Duk;Jeon, Sang Ryong
Journal of Korean Neurosurgical Society
/
v.30
no.sup2
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pp.316-321
/
2001
Objectives : The goal of this study is to evaluate the usefulness of mild hypothermia treatment in patients with increased intracranial pressure(ICP). Material and Method : From November 1999 to May 2001, 11 patients were treated with mild hypothermia ($32-34^{\circ}C$) in whom ICP maintained at higher than 20mmHg in spite of decompressive surgery and high dose barbiturate therapy. The patient's rectal temperature were lowered by external cooling. Hypothermia was maintained for not more than 7 days and then the patients were rewarmed slowly for 24 hours. If increased ICP persisted for 2 days of hypothermia, this treatment was continued for several days. The functional outcome of each patient was assessed according to Glasgow Outcome Scale(GOS). Results : All cases except two cases showed decrease of ICP after hypothermia therapy. In 1 case which was right middle cerebral artery(MCA) infarct, ICP re-increased after 24 hours and in another 1 case, ICP was not controlled initially. Among 11 cases, 3 cases showed favorable outcome. Conclusion : Mild hypothermia treatment in patients with increased ICP was effective in controlling ICP and mortality was so decreased. More clinical experience and controlled study was need to determine the effectiveness.
Objective : The purpose of this study was to investigate effects of depression and anxiety on treatment response of social skills training in adolescents with autism spectrum disorders (ASD). Methods : A total of 107 teenagers that participated in the Program for the Education and Enrichment of Relational Skills (PEERS$^{(R)}$) between 2011 and 2015 were analyzed using linear regression. Outcome measures used were the Korean version of Social Responsiveness Scale (SRS), the Test of Adolescent Social Skills Knowledge-Revised (TASSK-R), and the Korean version of Autism Diagnostic Observation Schedule (K-ADOS). Depression and anxiety were assessed by the Korean version of Child Depression Inventory (CDI), the Korean version of State and Trait Anxiety Inventory for Children (STAIC), and the Korean version of Child Behavior Checklist (K-CBCL). Results : As a result, depressive symptoms measured by CDI (p<0.05) and anxiety symptoms measured by STAIC (p<0.05) had significant influence on score change of social interaction domain of ADOS. It remained significant even after the baseline score was adjusted as covariates (p<0.05). Conclusion : We observed that pre-treatment anxiety and depressive symptoms of teenagers had significant effects on the treatment outcome of PEERS$^{(R)}$, especially in terms of face-to-face social interaction.
Background: Prader-Willi syndrome (PWS) is a complex genetic disease associated with growth impairment, severe obesity and metabolic dysfunctions. High proportion of PWS patients are born small for gestational age (SGA) than normal children, which also increase the risk of growth impairment and metabolic dysfunction in PWS. We aimed to compare growth outcome and metabolic profiles between SGA and appropriate for gestational age (AGA) PWS patients. Methods: Data of 55 PWS children and adults aged more than 2 years old (32 male and 23 female, age 2-18.8 years) from single center were studied. Only patients who were treated with GH were included. The clinical characteristics and laboratory findings were reviewed retrospectively. Results: Among 55 subjects, 39 had 15q11-13 deletion and 16 had uniparental disomy (UPD). Twenty (36.3%) were born SGA. All patients received GH treatment, and 11 (20%) discontinued GH treatment. Mean age at GH treatment initiation was 2.5 (range 0.3-12.4) years, and mean duration of treatment was 6.3 (range 1.0-11.3) years. Current height-SDS (-0.36 vs -0.16) and BMI-SDS (1.44 vs 1.33) did not differ between AGA and SGA group. Two patients in SGA group, but none in AGA group had diabetes mellitus. Mean glucose level was also higher in SGA group (100.1 vs 114.4 mg/dL). Conclusion: Our report gives an overview of growth profile and metabolic dysfunctions recorded in GH treated PWS patients. Growth profile did not differ between AGA and SGA group. Glucose level was higher in SGA group, so more careful monitoring and prevention for DM will be required in SGA group.
Kose, Selin Guven;Kose, Halil Cihan;Celikel, Feyza;Akkaya, Omer Taylan
The Korean Journal of Pain
/
v.35
no.4
/
pp.447-457
/
2022
Background: Ultrasound-guided genicular nerve radiofrequency (RF) procedures are of interest in the management of chronic knee pain. A wide variety of demographic, clinical, and procedural characteristics can affect treatment success. This study aimed to determine predictive factors to provide superior treatment outcomes. Methods: The demographic, clinical, and technical data of patients who received genicular nerve RF for knee pain between September 2016 and September 2021 were evaluated. A positive outcome was defined as at least 50% pain relief on a pain score for at least 6 months. Logistic regression analysis was performed to determine the factors associated with a successful response to genicular RF. Results: Among 206 patients who underwent genicular RF, 62% of the patients reported successful outcomes at 6 months. In the multivariate model, targeting 5 nerves (odds ratio [OR], 6.184; 95% confidence interval [CI], 2.291-16.690; P < 0.001) was the most significant predictor of successful outcomes. Multivariable logistic regression analysis showed that prognostic genicular nerve block with a 50% cut-off value (OR, 2.109; 95% CI, 1.038-4.287; P = 0.039), no opioid use (OR, 2.753; 95% CI, 1.405-5.393; P = 0.003), and depression (OR, 0.297; 95% CI, 0.124-0.713; P = 0.007) were the predictive factors significantly associated with response to genicular RF. Conclusions: Clinical and technical factors associated with better treatment outcomes were ultimately targeting more nerves, performing prognostic block, no opioid use, and no depression. These results are expected to be considered when selecting patients for genicular RF.
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