• The Journal of Korean Medicine
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• v.28 no.1 s.69
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• pp.224-236
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• 2007

Background : Chunghyul-dan is a combinatorial herbal medicine; previous studies reported it had therapeutic effects for microangiopathy, a major part in the progression of small vessel disease, as well as having anti-hypertensive, anti-hyperlipidemic, anti-apoptotic, anti-oxidative, and anti-inflammatory activities. Therefor, we examined the inhibitory effect of Chunghyul-dan on stroke recurrence in patients with small vessel disease. Methods : We prescribed Chunghyul-dan at 600 mg a day to patients with small vessel disease, and monitored stroke recurrence, drug compliances, and adverse effect for 1 year. We then performed follow-up brain MRI to find new vascular lesions after 1 year of Chunghyul-dan medication. For the subjects lost to follow-up, we assessed their prognosis after 1 year by telephone. Results : There were 73 subjects treated with Chunghyul-dan for 1 year; new vascular events were found in 3. Of the 85 subjects lost to follow-up, fifty four could be contacted, and eight of them had stroke recurrence. One year of Chunghyul-dan medication reduced the odds ratio of stroke recurrence by 75% compared to the subjects lost to follow-up and the rate increased to 88%, when adjusted for other relevant risk factors for stroke recurrence. These reductions were much higher than those of aspirin and other kinds of conventional anti-platelets. There was no adverse effect in any of the study subjects. Conclusions : We suggest Chunghyul-dan could be useful for inhibition of stroke recurrence. Further study with a randomized controlled trial is needed to confirm this suggestion.

• Journal of Chest Surgery
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• v.49 no.5
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• pp.329-336
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• 2016

Background: Guidelines for esophagogastroduodenoscopy (EGD) in the West allow the continued use of warfarin under therapeutic international normalized ratio (INR) level. In Korea, no guidelines have been issued regarding warfarin treatment before EGD. The authors surveyed Korean cardiac surgeons about how Korean cardiac surgeons handle warfarin therapy before EGD using a questionnaire. Participants were requested to make decisions regarding the continuation of warfarin therapy in two hypothetical cases. Methods: The questionnaire was administered to cardiac surgeons and consisted of eight questions, including two case scenarios. Results: Thirty- six cardiac surgeons at 28 hospitals participated in the survey, and 52.7% of the participants chose to stop warfarin before EGD in aortic valve replacement patients without risk factors for thromboembolism. When the patient's INR level was 2, 31% of the participants indicated that they would choose to continue warfarin therapy. For EGD with biopsy, 72.2% of the participants chose warfarin withdrawal, and 25% of the participants chose heparin replacement. In mitral valve replacement patients, 47.2% of the participants chose to discontinue warfarin, and 22.2% of the participants chose heparin replacement. For EGD with biopsy in patients with a mitral valve replacement, 58.3% of the participants chose to stop warfarin, and 41.7% of the participants chose heparin replacement. Conclusion: This study demonstrated that attitudes regarding warfarin treatment for EGD are very different among Korean surgeons. Guidelines specific to the Korean population are required.

• Therapeutic Science for Rehabilitation
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• v.10 no.3
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• pp.137-149
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• 2021

Objective : This study aimed to verify the effectiveness of ICT-Living Lab-based programs to promote the health of elderly residents in small and medium-sized cities, thus, providing basic data for solving the health and quality of life problems faced by modern society. Methods : The tow-month program included 14 elderly individuals visiting senior center located in W City, from October to November 2019. The program was organized by consulting four senior experts and one ICT expert. The program consisted of 10 min for advance assessment, 10 min for preparation activities, 30 min for main activities, and 10 min for finishing, and 60 min for eight sessions over two months, once a week. Results : EQ-5D increased from 0.76 to 0.84, compared to pre-assessment(p=.009^*). EQ-VAS scores increased from 36.43 to 65.71 (p=.001^*). MMSE-DS increased from 21.21 to 24.14 (p=.000^*). SGDS-K decreased from 3.36 to 3.21, but this was not statistically significant (p=.854). Conclusion : The ICT·Living Lab-based program could be used as a basic material for future research as one of the ways to improve health and quality of life by preventing and addressing the problems faced by the elderly in modern society.

• Therapeutic Science for Rehabilitation
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• v.12 no.3
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• pp.79-88
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• 2023

Objective : This study was to apply a cognitive rehabilitation group program based on sensory activity in patients with dementia living in a facility and to check its effectiveness on cognitive function, depression, and quality of life (QOL). Methods : Sensory-based cognitive rehabilitation group programs (20 sessions) were conducted for eight elderly with dementia over the age of 65 living in a nursing facility located in H-gun, Gangwon-do. The participants' cognitive function, depression level, and QOL were evaluated before and after the program. Results : The mean of Mini-Mental State Examination-Dementia Screening increased; however, there was no statistically significant difference. In contrast, the mean post-test score of the Subjective Memory Complaints Questionnaire decreased, and there was a statistically significant difference (p < .05). The mean post-evaluation score of Short Geriatric Depression Scale measured to confirm the decrease in depression compared to the pre-evaluation score, but there was no statistically significant difference. Finally, the mean post-evaluation score of the World Health Organization QOL assessment instrument-Brief confirmed the change in the QOL, and there was a statistically significant difference (p < .001). Conclusion : This study will provide the basis for suggesting the usefulness of developing a sensory activity-based cognitive rehabilitation group program for dementia patients living in facilities.

• Therapeutic Science for Rehabilitation
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• v.12 no.3
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• pp.7-18
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• 2023

Objective : This study aimed to confirm the research characteristics by analyzing the literature that applied the school readiness programs for children with disabilities. Methods : Studies were collected from the PubMed, Embase, Web of Science, and Research Information Sharing Service databases. The key terms were "School readiness" AND ("Occupational Therapy" OR "Rehabilitation") in English and Korean. Total eight articles were selected through the selection and exclusion criteria. Results : The programs included multi-type training, motor skill training, parent training, and mobile application training. The providers were psychologists, occupational therapists, physical therapists, speech pathologists, community workers, educators, and the psychologists who conducted most of the research. The program factors can be classified into academic function, motor function, social function, parental training, and others. Academic and social functions accounted for the largest proportion of the respondents. The intervention improved multiple skills, literacy, parenting skills, and gross fine motor function. Conclusion : This study aimed to provide basic data for school-based occupational therapy by analyzing school readiness programs for children with disabilities. Recently, interest in and research on school readiness has increased. Occupational therapists should also establish their roles in the field of school-related rehabilitation and provide various school-based occupational therapies.

• Journal of Digestive Cancer Research
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• v.6 no.1
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• pp.25-31
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• 2018

Background: In Korea, stomach cancer is the second most common malignancy and the third leading cause of cancer-related deaths. the time of diagnosis is very important for treatment so early detection and surgery are currently considered the mainstay of treatment, when diagnosed advanced with tumor extension through the gastric wall and direct extension into other organs, with metastatic involvement. Recently, new drugs, drug combinations, and multimodal approaches have been used to treat this disease and In cancers over expressing or amplifying HER2, the combination of cisplatin-fluoropyrimidine-trastuzumab is considered to be the treatment of reference. but At present, the choice of treatment schedule for HER2-negative tumors is based on the medical institution's preferences and adverse effects profile. The aim of this study was to evaluate the effectiveness and safety of using FOLFOX regimen as a first-line therapy or a salvage therapy in the patients with HER2-negative advanced or metastatic gastric cancer. Methods: We retrospective reviewed the patient medical record from March 2012 to July 2017. This study evaluated 113 patients. Sixty-eight patients were treated with the FOLFOX regimen for the first time (first-line group) and 45 patients were treated with the FOLFOX regimen as a second (35 patients) or third (10 patients) chemotherapy (salvage group). Results: In the first-line group, the response rate was 54.9%. In the salvage therapy group, the response rate was 24.4% and The difference was statistically significant (p=0.205). The median TTP of the first-line group was 10.7 months (95% confidence interval [95% CI], 7.8-13.7 months) and that of salvage line group was 6.1 months (95% CI, 3.8-8.4 months). The median OS of the first-line group was 15.8 months (95% CI, 12.7-18.9 months) and that of the salvage therapy group was 10.2 months (95% CI, 8.2-11.9 months). drug toxicity was similar andtolerable between two groups. Conclusion: In patients with unresctable metastatic gastric cancer, after failing to respond to first-line therapy, most patients have no alternative other than second-line therapy because the disease is highly progressive. if the performance status of the patient is good enough to be eligible to treatments beyond best supportive care. FOLFOX regimen can be a considerable therapeutic option for salvage treatment.

• Therapeutic Science for Rehabilitation
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• v.13 no.1
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• pp.75-86
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• 2024

Objective : The purpose of this study was to examine the effects of an occupational therapy program on the school readiness, focusing on adaptation skills and daily life skills, in children with developmental delays. Methods : The study involved a boy with developmental delay, aged 5 years and 8 months. The program was conducted twice a week, with a total of 8 sessions spread over 4 weeks. The Canadian Occupational Performance Measure (COPM) was employed, targeting class preparation and use of the toilet. Pre-post tests and follow-up evaluations were carried out to compare changes. Data analysis involved video recordings of the subject's performance. Results : The COPM results indicated improvements in both the performance and satisfaction levels for class preparation and toilet use. Processing skills showed seven improvements in class preparation and eight improvements in toilet use during post-testing. Activity performance observations further confirmed improvements in both class preparation and toilet use during post-test and follow-up evaluations. Conclusion : Occupational therapy improves school readiness (adaptation skill, daily living activity skill) for children with developmental delays, and has a positive effect on overall school readiness.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.600-612
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• 2021

Purpose To evaluate the long-term radiologic and clinical outcomes of stent-graft placement for the treatment of post-pancreaticoduodenectomy arterial hemorrhage (PPAH) based on the imaging findings of stent-graft patency and results of liver function tests. Materials and Methods We retrospectively reviewed the medical records of nine consecutive patients who underwent stent-graft placement for PPAH between June 2012 and May 2017. We analyzed the immediate technical and clinical outcomes and liver function test results. Stent-graft patency was evaluated using serial CT angiography images. Results All stent-grafts were deployed in the intended position for the immediate cessation of arterial hemorrhage and preservation of hepatic arterial blood flow. Technical success was achieved in all nine patients. Eight patients survived after discharge, and one patient died on postoperative day 28. The median follow-up duration was 781 days (range: 28-1766 days). Follow-up CT angiography revealed stent-graft occlusion in all patients. However, serum aspartate aminotransferase or alanine aminotransferase levels in all patients were well below those observed in hepatic infarction cases. Conclusion Stent-graft placement is a safe and effective treatment method for acute life-threatening PPAH. Liver function and distal hepatic arterial blood flow were maintained postoperatively despite the high incidence of stent-graft occlusion observed on follow-up CT.

• Therapeutic Science for Rehabilitation
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• v.13 no.3
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• pp.85-100
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• 2024

Objective : This case study aimed to explore dysphagia symptoms in post-cardiac transplantation patients and evaluate the effectiveness of dysphagia rehabilitation therapy in an occupational therapy clinic. Methods : A patient with post-cardiac transplant dysphagia underwent videofluoroscopic swallowing studies to assess the Functional Dysphagia Scale (FDS), Penetration-Aspiration Scale (PAS), and Dysphagia Outcome and Severity Scale (DOSS). Assessments were performed three times at two-week intervals. The treatment, administered from July 19 to August 21, 2023, included eight sessions of 30 minutes each. Treatments included corrective techniques (tongue-hold maneuver, chin tuck against resistance, mendelsohn maneuver, effortful swallowing, and respiratory muscle exercise) and compensatory strategies (chin-tuck position, multiple swallowing, modification of volume, and viscosity), alongside caregiver education. Results : The FDS scores decreased from 50 to 30, PAS scores improved from 5 to 3, and DOSS scores improved from Stage 2 to Stage 4. Conclusion : Dysphagia rehabilitation therapy improved swallowing function in a post-cardiac transplantation patient. However, further studies are required to confirm these findings.

• Radiation Oncology Journal
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• v.19 no.2
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• pp.142-145
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• 2001

Purpose : Acute leukemia with hyperleukocytosis (more than $10^5/mm^3$) is at high risk of early sudden death, usually from intracerebral hemorrhage. Emergency cranial irradiation is a relatively simple approach to solve this the problem. We summarized our experience of cranial irradiation in 24 leukemic children who presented with hyperleukocytosis. Methods and Materials : Between 1990 and 1998, 40 children with acute leukemia presenting with hyperleukocytosis were referred for emergency cranial irradiation. Among these patients, 24 children were evaluable. There were 16 boys and eight girls, their ages ranged from 2 to 13 years (median 9.5 years). The initial leukocyte counts ranged $109,910/mm^3\;to\;501,000/mm^3$. Peripheral blood smear was peformed in all patients and noted the morphology of the blast. Introduction of emergency cranial irradiation was determined by the leukocyte counts (more than 100,000/mm) and the existence of the blast in peripheral blood smear. All patients were treated with intravenous hydration with alkaline fluid and oral allopurinol. Cranial irradiation started on the day of diagnosis. With 2 Gy in one fraction in 4 patients, 4 Gy in two fractions in 20 patients. Results : The WBC count had fallen in 19 patients (83%) and no intracerebral hemorrhage occurred after irradiation. There were five cases of early deaths. Four patients died of metabolic complications, and one patient with intracerebral hemorrhage. He died 5 hours after cranial irradiation. No patient had any immediate side effect from cranial irradiation. Conclusion : Our data suggest, that emergency cranial irradiation can be safely chosen and effective in childhood leukemic patients presenting with high leukocyte counts.