• Tuberculosis and Respiratory Diseases
• /
• v.82 no.1
• /
• pp.15-26
• /
• 2019

The pathogen Mycobacterium avium complex (MAC) is the most common cause of nontuberculous mycobacterial pulmonary disease worldwide. The decision to initiate long-term antibiotic treatment is difficult for the physician due to inconsistent disease progression and adverse effects associated with the antibiotic treatment. The prognostic factors for the progression of MAC pulmonary disease are low body mass index, poor nutritional status, presence of cavitary lesion(s), extensive disease, and a positive acid-fast bacilli smear. A regimen consisting of macrolides (clarithromycin or azithromycin) with rifampin and ethambutol has been recommended; this regimen significantly improves the treatment of MAC pulmonary disease and should be maintained for at least 12 months after negative sputum culture conversion. However, the rates of default and disease recurrence after treatment completion are still high. Moreover, treatment failure or macrolide resistance can occur, although in some refractory cases, surgical lung resection can improve treatment outcomes. However, surgical resection should be carefully performed in a well-equipped center and be based on a rigorous risk-benefit analysis in a multidisciplinary setting. New therapies, including clofazimine, inhaled amikacin, and bedaquiline, have shown promising results for the treatment of MAC pulmonary disease, especially in patients with treatment failure or macrolide-resistant MAC pulmonary disease. However, further evidence of the efficacy and safety of these new treatment regimens is needed. Also, a new consensus is needed for treatment outcome definitions as widespread use of these definitions could increase the quality of evidence for the treatment of MAC pulmonary disease.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.34 no.4
• /
• pp.131-150
• /
• 2021

Objectives: The purpose of this study is to analyze the domestic study trends on Korean medicine treatment of Sanhupung. Methods: Case studies applying Korean medicine treatment on Sanhupung were searched through 5 domestic journal databases. General characteristics, interventions, outcomes, and results of the selected studies were analyzed. Also, the quality of the case studies was reviewed based on the CAse REport (CARE) guideline and Joanna Briggs Institute (JBI) critical appraisal checklist. Results: 11 studies (16 cases) were found to be analyzed according to their general characteristics, symptoms, interventions, treatment period, outcome, and results. The most common complaint of Sanhupung patients was pain, and the most applied intervention for Sanhupung was herbal medicine and acupuncture. The duration of treatment ranged from 9 days to 4 months. All case studies reported that the Korean medicine treatment was effective in treating Sanhupung. According to the quality assessment, 'Timeline of case', 'Diagnostic challenges', 'Intervention adherence and tolerability', 'Adverse and unanticipated events', and 'Informed consent' were showed low reporting rates. Conclusions: Further clinical studies are needed to establish the evidence for Korean medicine treatment for Sanhupung.

• Journal of Sasang Constitutional Medicine
• /
• v.33 no.1
• /
• pp.90-101
• /
• 2021

Objectives The purpose of this study was to evaluate intervention studies on Sasang Constitutional diet (SCD) through the checks of Participant, Intervention, Comparison, and Outcome (PICO) Methods Randomized controlled trial (RCT) and non-randomized study for intervention (NRSI) about SCD were searched in 4 Korean core databases and other sources, and then PICO was checked. Results 1. Total 10 studies were conducted with 1 RCT and 9 NRSIs. 2. Participants were people with no specific disease, or patients with essential hypertension, hyperlipidemia, obesity, or stroke with diabetes or hyperlipidemia. Most studies were conducted on groups of various Sasang Constitutional types except Taeyangin. 3. Two studies provided participants with meals and exercise. Three studies, instead of providing meals directly, taught participants how to eat SCD on their own. 4. NRSIs have tested the effectiveness of various outcome measures without the presentation of primary outcome, and then concluded that all outcomes were ineffective or some are effective. 5. There was no mention of adverse events. In most studies, a single doctor of Korean medicine diagnosed Sasang Constitution the QSCC II questionnaire. The intervention period ranged from three weeks to three months, and recent studies have conducted interventions for 12 weeks. Conclusions Intervention studies about SCD which were conducted so far have shown problems on the study design of PICO items. The study design and implementation that carefully consider how to maintain similarity between groups, minimize the risk of bias, set primary outcome measure, and control the diet are required.

• The Journal of Internal Korean Medicine
• /
• v.41 no.6
• /
• pp.1274-1281
• /
• 2020

Objective: This case report shows symptom improvements in stage IV metastatic colorectal cancer treated with a Korean medicine-based integrative cancer treatment (ICT). Methods: A 61-year-old male patient diagnosed with colorectal cancer in November 2017 and metastasis to the lung, peritoneum, and liver in September 2020 was treated with Integrative Cancer Treatment (ICT) for abdominal pain, abdominal discomfort, and anorexia for 1 month. Clinical outcomes were measured with the National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE), a numeral rating (NRS), the Eastern Cooperative Oncology Group (ECOG), and the Functional Assessment of Cancer Therapy-General (FACT-G) scales. Results: After treatment, the patient's abdominal pain was improved from NRS 8 to 1, and the ECOG score of the patient was improved from grade 3 to 2. Integrative Cancer Treatment. Also the score improved on the FACT-G test, and there were no serious side effects of grade 3 or higher according to the NCI-CTCAE. Conclusion: This case study suggests that Korean medicine-based ICT may help to improve abdominal pain and quality of life in patients with metastatic colorectal cancer.

• Journal of Chest Surgery
• /
• v.54 no.2
• /
• pp.117-126
• /
• 2021

Background: Several factors, such as the degree of target vessel stenosis, are known to be associated with radial artery (RA) graft patency in coronary artery bypass grafting (CABG). There is a lack of data regarding the effect of the RA proximal configuration (aortic anastomosis versus T-anastomosis). This study evaluated the effects of the RA proximal configuration on the patency rate and clinical outcomes after CABG. Methods: We conducted a retrospective study, analyzing 328 patients who had undergone CABG with an RA graft. We divided the patients into 2 groups. The primary endpoint was RA patency and the secondary endpoints were overall mortality and major adverse cardiac and cerebrovascular events (MACCE). We performed a propensity score-matched comparison. Results: Aorta-RA anastomosis was performed in 275 patients, whereas the rest of the 53 patients received T-RA anastomosis. The mean age was 67.3±8.7 years in the T-RA anastomosis group and 63.8±9.5 years in the aorta-RA anastomosis group (p=0.02). The mean follow-up duration was 5.13±3.07 years. Target vessel stenosis ≥70% (hazard ratio [HR], 0.42; 95% confidence interval [CI], 0.20-0.91; p=0.03) and T-RA anastomosis configuration (HR, 2.34; 95% CI, 1.01-5.19; p=0.04) were significantly associated with RA occlusion in the multivariable analysis. However, T-RA anastomosis was not associated with higher risks of overall mortality and MACCE following CABG (p=0.30 and p=0.07 in the matched group, respectively). Conclusion: Aorta-RA anastomosis showed a superior patency rate compared to T-RA anastomosis. However, the RA proximal anastomosis configuration was not associated with mortality or MACCE.

• The Korean Journal of Pain
• /
• v.34 no.2
• /
• pp.201-209
• /
• 2021

Background: Inguinal hernia repair is one of the most commonly performed surgical procedures. Regional blocks might provide excellent analgesia and reduce complications in the postoperative period. We aimed to compare the postoperative analgesic effect of the ultrasound-guided transversalis fascia (TF) plane block versus the transmuscular quadratus lumborum (QL) block in patients undergoing unilateral inguinal hernia repair. Methods: Fifty patients enrolled in this comparative study and were randomly assigned into two equal groups. One group received an ultrasound-guided QL block. In comparison, the other group received an ultrasound-guided TF plane block. The primary outcome was the patient-assessed resting, and movement-induced pain on the numeric pain rating scale (NRS) measured at 30 minutes postoperatively. Secondary outcomes included the percentage of patients receiving rescue analgesia in the first postoperative day, ease of performance of the technique, and incidence of adverse effects. Results: There were no statistically significant differences in NRS at rest and with movement between the groups over the first 24 hours postoperatively. The proportion of patients that received postoperative rescue analgesics during the first 30 minutes postoperatively was 4% (n = 1) in the QL group compared to 12% (n = 3) in the TF group. However, the mean performance time of the TF block was shorter than that of the QL block, and the performance of the TF block appeared easier technically. Conclusions: The ultrasound-guided TF plane block could be as effective as the QL block in lowering pain scores and decreasing opioid consumption following non-recurrent inguinal herniorrhaphy.

• Journal of Oriental Neuropsychiatry
• /
• v.33 no.2
• /
• pp.157-180
• /
• 2022

Objectives: To perform a systematic review of placenta pharmacopuncture for treating neuropsychiatric diseases, focusing on its efficacy and the safety so that evidence on its clinical use could be obtained, thus contributing to further studies. Methods: Through Korean, English, and Chinese databases (OASIS, Korean TK, KISS, RISS, ScienceON, Pubmed, Cochrane, EMBASE, CINAHL, AMED, CNKI, and Wanfang), combinations of keywords (placenta, pharmacopuncture, etc.) were used to select clinical studies published until January 2021 about placenta pharmacopuncture for neuropsychiatric diseases. Interventions included combined treatments. Study design included cases studies, series, and clinical trials. Cohort studies, literature reviews, in vitro and animal experiments were excluded. The primary outcomes involved measurements of symptoms, Visual Analogue Scale, or questionnaires. Data extracted from databases were imported to Endnote X7 to remove duplicates. The quality of the literature was assessed based on CAse REports Guidelines and Cochrane's Risk of Bias (ROB). Results: Twenty-one studies were selected, including ten case reports, three case series, two one-armed clinical trials, one non-randomized clinical trial, and five randomized clinical trials. There were six studies on sleep disorders, five studies on stroke sequela, two on mood disorders, two on enuresis, two on Guillain-Barré syndrome, two on multiple sclerosis, one on neurocognitive disorder, and one on vertigo. The most frequent combined treatment was acupuncture in both the experimental group (n=10) and the control group (n=3). Acupoints were ST36, SP6, BL23, CV4, GB20, GV20, N-HN54, and so on. All studies reported improvement of symptoms. The quality of case studies was relatively high. Assessment of ROBs resulted in low risks. Conclusions: Placenta pharmacopuncture is effective for neuropsychiatric diseases such as sleep disorders, mood disorders, enuresis, and neurocognitive disorders. Regarding insomnia, several studies have reported significant improvements with placenta pharmacopuncture. There was no adverse event associated with placenta pharmacopuncture.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.22 no.1
• /
• pp.29-37
• /
• 2022

Background: Pain, edema, and trismus are predictable sequelae for surgical extraction of impacted mandibular third molars (M3M). The present study aimed to compare the anti-phlogistic potential of bromelain and aceclofenac in the reduction of post-surgical sequalae in the extraction of impacted M3M. Method: A randomized controlled, triple-blinded clinical study included 72 patients scheduled for surgical removal of impacted M3M under local anesthesia. Randomization was performed and subjects were equally allocated to groups A (control) and B (study), who intended to receive aceclofenac and bromelain, respectively. The primary outcome variables were pain, edema, and trismus evaluated on postoperative days 2 and 7 and compared with baseline values. The secondary variables evaluated were the quantity of rescue analgesics required and the frequency of adverse effects in both groups for 7 postoperative (PO) days. Data were analyzed with a level of significance of P < 0.05. Results: Group B demonstrated a significant decrease in the severity of edema and trismus compared to group A on both PO days 2 and 7 (P < 0.001). Bromelain demonstrated similar analgesic efficacy with an insignificant difference compared to aceclofenac (P > 0.05). Conclusion: The present study showed that the efficacy of bromelain was comparable to that of aceclofenac in reducing inflammatory complications following surgical removal of impacted M3M. Bromelain can be considered a safe and potent alternative to routinely used aceclofenac when addressing inflammatory outcomes after surgery.

• Journal of Chest Surgery
• /
• v.55 no.3
• /
• pp.189-196
• /
• 2022

Background: This study investigated the predictive value of the frailty index calculated using laboratory data and vital signs (FI-L) in patients who underwent coronary artery bypass grafting (CABG). Methods: This study included 508 patients (age 67.3±9.7 years, male 78.0%) who underwent CABG between 2018 and 2021. The FI-L, which estimates patients' frailty based on laboratory data and vital signs, was calculated as the ratio of variables outside the normal range for 32 preoperative parameters. The primary endpoints were operative and medium-term all-cause mortality. The secondary endpoints were early postoperative complications and major adverse cardiac and cerebrovascular events (MACCEs). Results: The mean FI-L was 20.9%±10.9%. The early mortality rate was 1.6% (n=8). Postoperative complications were atrial fibrillation (n=148, 29.1%), respiratory complications (n=38, 7.5%), and acute kidney injury (n=15, 3.0%). The 1- and 3-year survival rates were 96.0% and 88.7%, and the 1- and 3-year cumulative incidence rates of MACCEs were 4.87% and 8.98%. In multivariable analyses, the FI-L showed statistically significant associations with medium-term all-cause mortality (hazard ratio [HR], 1.042; 95% confidence interval [CI], 1.010-1.076), MACCEs (subdistribution HR, 1.054; 95% CI, 1.030-1.078), atrial fibrillation (odds ratio [OR], 1.02; 95% CI, 1.002-1.039), acute kidney injury (OR, 1.06; 95% CI, 1.014-1.108), and re-operation for bleeding (OR, 1.09; 95% CI, 1.032-1.152). The minimal p-value approach showed that 32% was the best cutoff for the FI-L as a predictor of all-cause mortality post-CABG. Conclusion: The FI-L was a significant prognostic factor related to all-cause mortality and postoperative complications in patients who underwent CABG.

• Animal Bioscience
• /
• v.35 no.5
• /
• pp.711-720
• /
• 2022

Objective: The objective of this study was to determine the appropriate amount of eri silkworm pupae meal (Samia ricini) to add to the broiler diet. Methods: Two hundred 1-day-old male chicks with initial weight at 50.03±0.56 g/chick were divided into four groups (five replicates per group and ten chicks per replicate): a control group fed a corn-soybean diet and experimental groups supplemented with 5%, 10%, or 15% eri silkworm pupae meal. All experimental diets were isocaloric and isonitrogenous and formulated respecting nutrient requirements. Growth performances were collected during the experimental period and other parameters were collected at the end of experiment when broilers reached thirty-eight days old. Results: A higher cold carcass weight and skin yellowness in the broilers fed 10% eri silkworm pupae meal compared with the other groups (p<0.05). Therefore, supplementation with 10% eri silkworm pupae meal is suggested for the broiler diet formulation because it did not cause any serious negative consequences on growth performance, health status, carcass characteristics and meat quality. However, the usage of eri silkworm pupae meal at 15% is not recommend because it led to negative outcomes Conclusion: The addition of eri silkworm pupae at 10% can be used as an alternative protein sources for broiler chickens which provided benefits on cold carcass weight and skin yellowness without adverse effects.