• 대한의용생체공학회:의공학회지
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• 제40권5호
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• pp.143-150
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• 2019

To evaluate the toxicity of ophthalmic drug, the Draize test and Bovine Corneal Opacity and Permeability (BCOP) test commonly used. In Draize test, experimental animals were under stress and pain due to long-term exposure of drug. In addition, regarding physiological functions, animal model is not perfectly reflected a human eye condition. Although some models such as $EpiOcular^{TM}$, HCE model, LabCyte Cornea-Model, and MCTT $HCE^{TM}$ were already presented advanced cornea ex-vivo model to replace animal test. In this sense, cornea tissue structure mimicked ex-vivo toxicity model was fabricated in this study. The corneal epithelial cells (CECs) and keratocytes (CKs) isolated from rabbit eyeball were seeded on non-patterned silk film (n-pSF) and patterned silk film (pSF) at $32,500cells/cm^2$ and $6,500cells/cm^2$. Sequentially, n-pSF and pSF were stacked to mimic a multi-layered stroma structure. The thickness of films was about $15.63{\mu}m$ and the distance of patterns was about $3{\mu}m$. H&E stain was performed to confirm the cell proliferation on silk film. F-actin of CKs was also stained with Phalloidin to observe the cytoskeletal alignment along with patterns of the pSF. In the results, CECs and CKs were shown the good cell attachment on the n-pSF and pSFs. Proliferated cells expressed the specific phenotype of cornea epithelium and stroma. In conclusion, we successfully established the ex-vivo cornea toxicity model to replace the eye irritation tests. In further study, we will set up the human ex-vivo cornea toxicity model and then will evaluate the drug screening efficacy.

• 대한한방소아과학회지
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• 제35권3호
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• pp.67-88
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• 2021

Objectives The purpose of this study is to analyze randomized clinical trials (RCTs) on traditional Chinese medicine to summarize its efficacy and safety for the treatment of functional gastrointestinal disorders (FGIDs) in children. Methods We searched literatures published up to March 19, 2021 using two Chinese electronic databases. Data regarding patients, interventions, results, and adverse events were extracted from RCTs of herbal medicine for children with FGIDs. Results A total of 34 RCTs were included: 16 trials on functional dyspepsia, 7 trials on functional constipation, 6 trials on functional abdominal pain, 4 trials on irritable bowel syndrome, and 1 trial on functional diarrhea. 26 of 29 trials that reported total effective rate, the treatment group showed a significant improvement compared to the control group. Most of other evaluation indicators, such as symptom score, symptom disappearance time, and recurrence rate also demonstrated statistically significant improvement. Of the 16 studies which reported safety, 5 studies reported no adverse reactions in either group, and 4 studies reported no statistically significant differences in the incidence of adverse events between two groups. Also, reported adverse events were mostly mild. Conclusions Herbal medicine may help improve symptoms of FGIDs in children. However, due to limited types of studies on sub-diseases of FGIDs and small sample sizes in each study, additional large scale clinical studies on various other FGIDs are necessary.

• 대한정형도수물리치료학회지
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• 제27권2호
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• pp.77-85
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• 2021

BACKGROUND: This study aimed to determine the changes in muscle strength and walking ability in patients who complained of knee instability due to excessive pronation of the foot. METHODS: Twenty patients (ten men and ten women) who complained of instability of the knee joint due to excessive pronation of the foot participated in the experiment. In the experimental group, the internal rotation of the tibia caused by excessive adduction of the foot was maintained as external rotation, and the joint state was to recognize the movement of the joint position changed through maintenance of the muscle. This exercise was performed five times for each patient, and the muscle strength maintenance was performed for 20 seconds. In the control group, stretching and range of motion (ROM) exercises were performed. For the stretching exercise, one specific motion was performed for 20 second, and the ROM exercise was performed to confirm the change in muscle strength in the knee joint area and walking ability. RESULTS: The knee flexion and extension strength in the patients with excessive pronation of the foot differed significantly from those in the subjects from the control group (p<.05). Further, the before-after comparison of the step time and length in the evaluation of walking ability, which affects overall postural movement due to knee joint instability, revealed a significant difference between the experimental and control groups (p<.05). CONCLUSION: The patients that were subjected to manual therapy and ROM exercise for the knee joint showed improved knee joint muscle strength and walking ability compared to the subjects from the control group.

• Clinical Endoscopy
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• 제51권6호
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• pp.576-583
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• 2018

Background/Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) remains the most common EUS-guided tissue acquisition technique. This study aimed to evaluate the performance of a new Franseen tip fine needle biopsy (FNB) device for EUSguided sampling of solid lesions and compare it with the historical FNA technique. Methods: $Acquire^{(R)}$ 22 G FNB needle (Boston Scientific Co., Natick, MA, USA) was used for solid tumor sampling (Study group). Tissue was collected for rapid on-site evaluation, and touch and crush preparations were made. Historical EUS-FNA samples obtained using $Expect^{(R)}$ 22 G FNA needle (Boston Scientific Co.) were used as controls (Control group). All specimens were independently evaluated by two cytopathologists blinded to the formal cytopathological diagnosis. Results: Mean cell block histology scores were significantly higher (p=0.046) in the FNB group (51 samples) despite a significantly lower (p<0.001) mean number of passes compared to the FNA group (50 specimens). The overall diagnostic yields for the FNB vs. FNA groups were 96% vs. 88%. The degree of tumor differentiation was adequately assessed in all cell block qualifying lesions in the FNB group. Two patients developed post-FNB abdominal pain. Conclusions: The new Franseen tip FNB device provides histologically superior and cytologically comparable specimens to those obtained by FNA, but with fewer passes.

• 대한의용생체공학회:의공학회지
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• 제40권2호
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• pp.68-74
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• 2019

Lateral epicondylitis is caused by repeated use of the wrist, which causes inflammation and pain in the wrist extensor and tendon of the humerus. Delayed onset muscle soreness (DOMS) caused by repetitive resistance exercise affects the tendons connected in series with the muscle, leading to lateral epicondylitis. Although micro-current stimulation has been suggested as a possible treatment for tendinitis, there are insufficient studies on specific variables such as frequency. In this study, 15 healthy adult males and females developed DOMS in the wrist extensor and tendon in the humerus. The experimental group consisted of a low frequency group applying 20 Hz and a high frequency group applying 100 Hz according to the micro-current frequency. Each subject underwent an experiment for 5 days after DOMS, and the recovery rates were compared by measuring AROM, GPT, MST, PPT, and VAS. As a result, the 20 Hz group showed significant changes in AROM, MST, and VAS compared to the control group on the 4th day, and the recovery rate was also higher than that of the 100 Hz group. On the 5th day, recovery rate of 100 Hz group was higher than 20 Hz in AROM and PPT, and MST showed higher recovery rate than 20 Hz group, but there was no significant difference. These results indicate that microcurrent stimulation is effective for the treatment of delayed myalgia and tendon inflammation and that the 100 Hz group has faster recovery than the 20 Hz group.

• Clinics in Shoulder and Elbow
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• 제22권2호
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• pp.61-69
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• 2019

Background: The purpose of this study is to compare the clinical outcomes of the control group and platelet-rich plasma (PRP) group among the patients who failed to respond to conservative treatment as outpatient-based therapy for rotator cuff tendinopathy, and to compare the clinical results of leukocyte-poor (LP) PRP and leukocyte-rich (LR) PRP. Methods: Inclusion criteria are (1) over 18-year-old, (2) patients with rotator cuff tendinopathy, no rotator cuff tear by radiologic diagnosis (ultrasonography or magnetic resonance imaging) within the last 3 months, and (3) not effective to conservative treatment for more than 1 month. Of the final 60 subjects, 33 patients in the exercise treatment group and 27 patients in the PRP injection group (LP-PRP, 13; LR-PRP, 14) were included. Clinical evaluation was carried out by assessing the outcomes of treatment using the Numeric Rating Scale pain score, the American Shoulder and Elbow Society (ASES) score, and the Constant score at baseline and at 3 and 6 months after the procedure. Results: There was a statistically significant difference in ${\Delta}ASES_{3months}$ ($ASES_{3months}-ASES_{first}$) score between the control and PRP groups (p=0.006). However, there was no statistical significance between LP-PRP and LR-PRP groups (p>0.05). Conclusions: This study showed that PRP injection was more effective than exercise therapy for the first 3 months. However, there was no difference between the LP-PRP group and the LR-PRP group. Regardless of the type of PRP, clinical application of PRP injection in patients with rotator cuff tendinopathy seems to be effective in early treatment.

• 한방재활의학과학회지
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• 제31권4호
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• pp.167-191
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• 2021

Objectives Degenerative osteoarthritis of knee is a disease with an increasing number of patients worldwide and its general treatments have some side effects. Methods 102 subjects were classified into test group 1, test group 2, and control group, and clinical trial products were taken for 12 weeks. The effectiveness was evaluated with changes in visual analogue scale, Korean-Western Ontario and McMaster Universities Osteoarthritis Index, inducible nitric oxide synthase, and cyclooxygenase-2. Results Both test group 1 and test group 2 were effective in reducing the pain of degenerative osteoarthritis of knee, and only test group 2 was effective in improving the ability to perform daily activities. No clinically significant changes were observed for any safety parameter. Conclusions In conclusion, the data of this study indicate that Zanthoxylum piperitum leaf extract has effectiveness and safety against mild degenerative osteoarthritis of knee.

• 대한정형도수물리치료학회지
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• 제27권2호
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• pp.69-76
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• 2021

Background: Degenerative arthritis accounts for a large portion of the elderly, causing a lot of inconvenience in daily life. Total knee replacement (TKR) are performed to relieve pain in the knee joint. The purpose of this study was to determine whether knee joint stabilization exercises are effective in improving balance and walking ability in degenerative arthritis patients who have undergone TKR. Methods: A total of 30 TKR patients participated in this study. They were assigned to two groups. The experimental group, the group that underwent knee stabilization exercises, joint mobilization and general physical therapy. On the other hand, and the controlled group, the group that underwent joint mobilization and general physical therapy. All exercises were conducted thrice a week, for four weeks. The main balance outcomes were evaluated using the posture balance training system, while walking ability was assessed using a wireless 3-axis accelerometer. Results: The experimental group had significantly higher scores in postural stability testing (PST), limits stability testing, and waling ability. The post-intervention evaluation, there were significant differences in all variables between the two groups. However, no significant difference was noted in the foam eyes closed test in PST. Conclusion: This study suggests that knee joint stabilization exercises effectively improve the balance and walking ability of TKR patients. Thus, it could be presented as useful in clinical practice.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권3호
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• pp.279-287
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• 2021

Purpose: The clinical implications of bowel wall thickening (BWT) on abdominal computed tomography (CT) among children are unknown. We aimed to suggest a new method for measuring BWT and determining its clinical significance in children. Methods: We retrospectively analyzed 423 patients with acute abdomen who underwent abdominal CT; 262 were classified into the BWT group. For this group, the pediatric radiologist described the maximal bowel wall thickness (MT), normal bowel wall thickness (mm) (NT), and their ratios for each segment of the bowel wall. Results: In the thickened bowel walls, the thickness differed significantly between the small bowel (6.83±2.14 mm; mean±standard deviation) and the colon (8.56±3.46 mm; p<0.001). The ratios of MT to NT in the small bowel (6.09±3.17) and the colon (7.58±3.70) were also significantly different (p<0.001). In the BWT group, 35 of 53 patients had positive fecal polymerase chain reaction results; 6 patients infected with viruses predominantly had BWT in the small intestine, while the terminal ileum and the colon were predominantly affected in 29 patients with bacterial infections. In the initially undiagnosed 158 patients with BWT, the symptoms improved spontaneously without progression to chronic gastrointestinal disease. Conclusion: This study provides a clinical reference value for BWT in the small intestine and colon using a new method in children. The BWT on abdominal CT in children might indicate nonspecific findings that can be observed and followed up without additional evaluation, unlike in adults.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권1호
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• pp.100-108
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• 2021

Purpose: Percutaneous endoscopic gastrostomy (PEG) tube placements are commonly performed pediatric endoscopic procedures. Because of underlying disease, these patients are at increased risk for airway-related complications. This study compares patient characteristics and complications following initial PEG insertion with general endotracheal anesthesia (GETA) vs. anesthesia-directed deep sedation with a natural airway (ADDS). Methods: All patients 6 months to 18 years undergoing initial PEG insertion within the endoscopy suite were considered for inclusion in this retrospective cohort study. Selection of GETA vs. ADDS was made by the anesthesia attending after discussion with the gastroenterologist. Results: This study included 168 patients (GETA n=38, ADDS n=130). Cohorts had similar characteristics with respect to sex, race, and weight. Compared to ADDS, GETA patients were younger (1.5 years vs. 2.9 years, p=0.04), had higher rates of severe American Society of Anesthesiologists (ASA) disease severity scores (ASA 4-5) (21% vs. 3%, p<0.001), and higher rates of cardiac comorbidities (39.5% vs. 18.5%, p=0.02). Significant associations were not observed between GETA/ADDS status and airway support, 30-day readmission, fever, or pain medication in unadjusted or adjusted models. GETA patients had significantly increased length of stay (eβ=1.55, 95% confidence interval [CI]=1.11-2.18) after adjusting for ASA class, room time, anesthesia time, fever, and cardiac diagnosis. GETA patients also had increased room time (eβ=1.20, 95% CI=1.08-1.33) and anesthesia time (eβ=1.50, 95% CI=1.30-1.74) in adjusted models. Conclusion: Study results indicate that younger and higher risk patients are more likely to undergo GETA. Children selected for GETA experienced longer room times, anesthesia times, and hospital length of stay.