• The Journal of Internal Korean Medicine
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• v.43 no.6
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• pp.1264-1273
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• 2022

Posterior communicating artery aneurysms (PcomAAs) are the second most common type of aneurysm. Large cerebral aneurysms show various neurological symptoms, especially oculomotor nerve palsy (ONP), due to PcomAAs. Recent research has shown that stent-assisted coil embolization has many side effects. We report the effectiveness of Korean medicine in the treatment of ONP due to PcomAAs after stent-assisted coil embolization. A patient with ptosis and limitation of eye movement was treated with Korean medicine, including herbal medicine (Samlyeongbaegchul-san-byeonbang [參苓白朮散變方] and Uwhangchungsim-won [牛黃淸心元]), acupuncture, electroacupuncture, cupping, and moxibustion. Clinical symptoms were observed by images of the inter-palpebral fissure and eyeball movement. After the treatment, the inter-palpebral fissure and eyeball movement were noticeably improved. These findings suggest that treatment with Korean medicine can be an effective option for the treatment of ONP due to PcomAAs after stent-assisted coil embolization.

• Journal of Service Research and Studies
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• v.12 no.3
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• pp.26-44
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• 2022

Job stress experienced during work has a positive effect on the organization, such as performance improvement, but if not properly managed, it can cause physical diseases such as digestive diseases and mental diseases such as depression and neurological diseases. If job stress persists for a long time, it causes emotional exhaustion and depression, which has a significant adverse effect on individuals and organizations, so proper management is essential. Therefore, in this study, a descriptive survey study was conducted using a self-report questionnaire method to find out the relationship between job stress, emotional exhaustion and depression of medical institution workers. As a result of the analysis, it was found that job stress of medical institution workers had a significant (+) effect on emotional exhaustion and depression, and emotional exhaustion of medical institution workers had a significant (+) effect on depression. Through this study, it was found that there was a significant relationship between job stress, emotional exhaustion, and depression of hospital employees, and that emotional exhaustion acts as a parameter in the relationship between job stress and depression. Considering that job stress of hospital employees causes adverse organizational effects, such as threatening workers' mental and physical health and causing deterioration in the quality of medical services, organizational efforts will be needed to relieve and properly manage job stress of hospital employees.

• Journal of Korean Neurosurgical Society
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• v.66 no.1
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• pp.72-81
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• 2023

Objective : Ischemia and hemorrhage of pituitary adenomas (PA) caused important clinical syndrome. However, the differences on clinical characteristics and surgical outcomes between these two kinds apoplexy were less reported. Methods : A retrospective analysis was made of patients with pituitary apoplexy between January 2013 and June 2018. Baseline and clinical characteristics before surgery were reviewed. All patients underwent transsphenoidal surgery and were followed up at least 1 year. Results : Total 67 cases (5.8%) among 1147 pituitary tumor patients were enrolled, which consisted of 28 (~2.4%) ischemic PA and 39 (~3.4%) hemorrhagic PA. There were more male patients in the ischemic group compared with hemorrhagic group (78.6% vs 53.8%, p=0.043). However, the mean age, tumor size and functional tumor ratio were significant higher in the hemorrhagic group. Headache was more common in ischemic PA (82.1%) than that of hemorrhagic PA (51.3%, p=0.011). Magnetic resonance imaging findings found that mucosal thickening and enhancement of the sphenoid sinus was observed in 15 ischemic PA patients (n=27, 55.6%), but none in patients with hemorrhagic PA (n=38, p<0.0001). It was worth noting that the rate of pre-surgical hypopituitarism in ischemic PA patients were seemed higher than that in hemorrhagic PA patients, but not significant. The two groups got a total tumor resection rate at 94.1% and 92.9%, independently. No significant difference on the operative time, blood loss in operation and complications in perioperative period was observed in two groups. After operation, cranial nerve symptoms recovered to normal at 81.8% of ischemic PA patients and 82.6% of hemorrhagic PA patients. Importantly, the incidence of postoperative hypopituitarism partially decreased in both groups, among which the rate of hypothyroidism in ischemic PA patients significantly decreased from 46.4% to 18.5% (p=0.044). Conclusion : Patients with ischemic PA presented different clinical characteristics to the hemorrhagic ones. Transsphenoidal surgery should be considered for the patients with neuro-ophthalmic deficits and might benefit for pituitary function recovery of the apoplectic adenoma patients, especially pituitary thyroid axis in ischemic PA patients.

• Therapeutic Science for Rehabilitation
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• v.12 no.2
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• pp.43-53
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• 2023

Objective : In this study, the rehabilitation motivation evaluation tool for stroke patients was identified, and the characteristics of the evaluation tool were analyzed to analyze the conceptual framework and characteristics used in the composition of the evaluation contents. Methods : From 2000 to May 2022, documents registered in major domestic and foreign databases (PubMed, NDSL, Medline, and EMbase) were searched and selected according to the selection and exclusion criteria. The evaluation tools used in the selected documents were analyzed, and the characteristics of this evaluation tool were analyzed. Results : A total of 30 documents were selected, and they were classified into a total of five rehabilitation motivation evaluation tools. The most widely used in Korea was the measurement tool for rehabilitation motivation for the disabled, and the most widely used overseas was the intrinsic motivation inventory. Three evaluation tools constructed the evaluation contents based on the self-determination theory, and two constructed the evaluation contents through expert agreement. The number of evaluation items and 8 to 45 items were varied, and the evaluation scale was also used in various ways from 4 to 7 point scale. Conclusion : It was possible to identify the evaluation tools mainly used for the evaluation of rehabilitation motivation, and to identify the main conceptual framework based on the development of the rehabilitation motivation evaluation tool. The results of this study are expected to be used as basic data for research on the development of rehabilitation motivation evaluation tools for stroke patients in the future.

• Therapeutic Science for Rehabilitation
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• v.12 no.2
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• pp.55-68
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• 2023

Objective : This study aims to analyze the effects of visual perception intervention by systematically reviewing the studies that applied visual perception intervention to children with cerebral palsy. Methods : The databases used were PubMed, EMbase, Science Direct, ProQuest, Koreanstudies Information Service System (KISS), Research Information Sharing Service (RISS), and the National Assembly Library. The keywords used were cerebral palsy, CP, and visual perception. According to the PRISMA flowchart, 10 studies were selected from among studies published from January 1, 2012 to March 30, 2022. The quality level of the selected studies, the demographic characteristics of study participants, the effectiveness of interventions, area and strategies of intervention, assessment tools to measure the effectiveness of interventions, and risk of bias were analyzed. Results : All selected studies confirmed that visual perception intervention was effective in improving visual perception function. In addition, positive results were shown in upper extremity function, activities of daily living, posture control, goal achievement, and psychosocial areas as well as visual perception function. The eye-hand coordination area was intervened in all studies. Conclusion : In visual perception intervention, It is necessary to evaluate the visual perception function by area, and apply systematically graded customized interventions for each individual.

• Therapeutic Science for Rehabilitation
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• v.12 no.2
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• pp.69-83
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• 2023

Objective : This study, as a preliminary study, applied an Information & Communication Technology (ICT) home-based program to elderly people aged 65 years or older to confirm the effect of the cognitive enhancement program and to find the possibility of remote rehabilitation. Methods : This study from August to October 2022, three subjects were selected and the intervention was conducted for about 2 months. This intervention was conducted using Korean version of Mini-Mental State Examination, Korean version of Montreal Cognitive Assessment (MoCA-K), Computer Cognitive Senior Assessment System, and the Center for Epidemiologic Studies Depression scale to evaluate cognitive improvement before and after the program. The therapist remotely set the level of cognitive training according to the subject's level through weekly feedback. Results : After the intervention, all subjects showed improved scores in most items of the MoCA-K conducted before and after the intervention. In addition, among the items of Cotras-pro, upper cognition, language ability, attention, visual perception, and memory were improved. Conclusion : Cognitive rehabilitation training using an ICT home-based program not only prevented dementia but also made it habitual. Through this study, it was confirmed that remote rehabilitation for the elderly could be possible.

• Therapeutic Science for Rehabilitation
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• v.12 no.2
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• pp.85-98
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• 2023

Objective : We investigated the efficacy of an artificial intelligence computerized cognitive training program using motion capture to identify changes in cognition, depression, and quality of life in older adults with mild cognitive impairment. Methods : A total of seven older adults (experimental group = 4, control group = 3) participated in this study. During the COVID-19 period from October to December 2021, we used a program, "MOOVE Brain", that we had developed. The experimental group performed the program 30 minutes 3×/week for 1 month. We analyzed patients scores from the Korean version of the Mini-Mental State Examination-2, the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet for Daily Life Evaluation, the short form Geriatric Depression Scale, and Geriatric Quality of Life Scale. Results : We observed positive changes in the mean scores of the Stroop Color Test (attention), Stroop Color/Word Test (executive function), SGDS-K (depression), and GQOL (QoL). However, these changes did not reach statistical significance for each variable. Conclusion : The study results from "MOOVE Brain" can help address cognitive and psychosocial issues in isolated patients with MCI during the COVID-19 pandemic or those unable to access in-person medical services.

• Therapeutic Science for Rehabilitation
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• v.12 no.2
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• pp.9-23
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• 2023

Objective : Among the studies using neglect interventions in the field of occupational therapy, this study was conducted to confirm the contents and characteristics of literature applying single-subject studies, and to analyze the intervention effect and quality level. Methods : This study is a systematic review, and the single subject study published in academic journals for the last 10 years. Results : As a result of the thesis analysis, it was conducted on stroke, and the removal design with seven studies, and two studies were multiple baseline designs. As a result of analyzing the size of the intervention effect applied to neglect, 'highly effective' was found seven times, 'fairly effective' 18 times, 'questionable effective' five times, and 'unreliable effective' six times. As a result of the quality level, there were no studies with low level, with six high level and three medium level. Conclusion : As a result of the study, various methods were applied to neglect interventions. It is thought that this study will provide basic data for evidence-based interventions.

• Therapeutic Science for Rehabilitation
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• v.12 no.2
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• pp.25-42
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• 2023

Objective : The purpose of this study was to identify the characteristics of a single-subject research study and qualitative levels in which occupational therapy interventions were performed on children with cerebral palsy. Methods : This study targeted papers, published in Research Information Sharing Service (RISS), National Digital Science Library (NDSL), Koreanstudies Information Service System (KISS), and E-article from May 20 to 29, 2022. The search terms were 'cerebral palsy' AND 'single subject research design' OR 'individual subject study'. Eleven papers, were finally selected and analyzed. Results : Most of the studies were medium in methodological quality, and the subjects were pre-school age and spastic hemiplegia. Among the single-subject designs, intervention-removal designs were the most common, and among them, ABA designs were the most common. Interventions included assistive devices, constraint-induced therapy, neurodevelopmental therapy, and sensory integration therapy were 2, and upper extremity exercise, interactive metronome, and CO-OP were 1. Dependent variables were measured with 2 to 4 measurement tools, Significant improvements were found in postural control ability, gait and balance, hand function, and upper extremity function. Conclusion : This study confirmed that it is helpful to apply cerebral palsy occupational therapy by presenting the characteristics of cerebral palsy, intervention sessions and effects, measurement tools and methodological quality levels.

• The Journal of Internal Korean Medicine
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• v.44 no.2
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• pp.231-243
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• 2023

Background: Diabetic polyneuropathy is the most common complication in diabetics, occurring in 50% of all cases. About 10-20% of all diabetics are accompanied by neurological pain, showing a tendency to increase with age. Clinical aspects are very diverse, from mild abnormalities on nerve conduction tests to severe abnormalities in all sensory, motor, and autonomic nerves; however, sensory symptoms usually precede motor symptoms. Patients typically express sensory symptoms, such as positive and negative symptoms, which decrease the quality of life and have marked clinical implications, such as increased morbidity and mortality. Although Western medical drugs, such as tricyclic antidepressants, anticonvulsants, and narcotic analgesics, are used for diabetic polyneuropathy, a standard treatment has not been established. Case report: A 65-year-old male with paresthesia and pain due to diabetic polyneuropathy was treated with Uchashinki-hwan, acupuncture, electroacupuncture, moxibustion, and Jungsongouhyul pharmacopuncture for 10 days. We used the Toronto Clinical Neuropathy Scoring System, EuroQol-5 Dimension, and Visual Analog Scale to evaluate symptoms. Subsequently, the Neuropathy Scoring System, EuroQol-5 Dimension, and subjective discomfort improved. Conclusion: The present case report suggests that combined Korean medicine treatment might be an effective treatment for paresthesia and pain with diabetic polyneuropathy. Several follow-up studies should be conducted to clarify the effectiveness of the treatment.