• Title/Summary/Keyword: clinical efficacy

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Stereotactic Radiosurgery for Dural Arteriovenous Fistulas Involving the Transverse-Sigmoid Sinus : A Single Center Experience and Review of the Literatures

  • Baek, Hong-Gyu;Park, Seong-Hyun;Park, Ki-Su;Kang, Dong-Hun;Hwang, Jeong-Hyun;Hwang, Sung-Kyoo
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.458-466
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    • 2019
  • Objective : We retrospectively assessed the efficacy of stereotactic radiosurgery (SRS) for dural arteriovenous fistulas (DAVFs) involving the transverse-sigmoid sinus and analyzed the angiographic and clinical results with our 8-year experience. Methods : Nine patients with intracranial DAVFs involving the transverse-sigmoid sinus underwent SRS using a Gamma $Knife^{(R)}$ (Elekta Inc., Atlanta, GA, USA) between 2009 and 2016. Five patients underwent SRS for residual DAVFs after embolization and four patients were treated with SRS alone. The median target volume was $1.9cm^3$ (range, 0.8-14.2) and the median radiation dose of the target was 17 Gy (range, 16-20). The median follow-up period was 37 months (range, 7-81). Results : Pulsating tinnitus (33%) was the most common symptom. DAVFs were completely obliterated in four patients (44%) and subtotally obliterated in five (56%). Six patients (67%) showed complete recovery of symptoms or signs, and three (33%) showed incomplete recovery. One patient experienced a recurrent seizure. Adverse radiation effects after SRS occurred in one patient (11%). The total obliteration rates after SRS were 16.7%, 37.5%, and 68.7% at 1, 2, and 3 years, respectively. The median interval from SRS to total obliteration of the fistula was 31 months (range, 12-38). The rates at which the symptoms started to improve were 40% at 1 month and 80% at 2 months after SRS. Symptoms started to improve at a median of 5 weeks after SRS (range, 3-21). Conclusion : SRS with or without embolization is a safe and effective treatment to relieve symptoms and obliterate DAVFs on the transverse-sigmoid sinus.

Effect of Chuna Manual Therapy for Peripheral Facial Paralysis in Children : A Systematic Review (소아 말초성 안면마비에 대한 추나요법의 효과 : 체계적 문헌고찰)

  • Kim, Eui-Byeol;Kang, Ki-Wan;Kim, Min-Woo;Ko, Youn-Seok
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.14 no.1
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    • pp.1-11
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    • 2019
  • Objectives : The purpose of this study is to review clinical studies about the effect of chuna manual therapy (CMT) for peripheral facial paralysis in children. Methods : In this review, we searched 11 electronic databases (Pubmed, Cochrane Library, EMBASE, CINAHL, CAJ, Oasis, NDSL, KISS, RISS, KISTI, Dbpia); We concluded our literature search in April 23, 2019. We included only randomized controlled trials (RCTs) of testing CMT for peripheral facial paralysis in children. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. The meta-analysis was performed by synthesizing outcome data of total efficacy rate (TER). Results : After screening papers, a total of 6 RCTs were selected and analyzed. In the 6 RCTs, patients(n=15-60 per study) were randomized into groups for treatment and control. Specifically, the treatment group received CMT, while the control group was concurrently given usual care, such as acupuncture and medicine. The meta-analysis showed that the treatment group receiving CMT alone showed significant improvement in TER, compared to the control group receiving acupuncture therapy alone(P<0.05). And the treatment group receiving CMT combined with usual care showed positive results, in terms of TER, compared to the control group receiving usual care, but was not statistically significant(P>0.05). Conclusions : Our analysis suggests that CMT has therapeutic effects for peripheral facial paralysis in children. However, to confirm this result, further investigation accompanied by high quality studies is required.

A Systematic Review and Meta-Analysis of Randomized Controlled Trials on Chuna Manual Therapy for Cervicogenic Headache

  • Lee, Dong-Wha;Kim, Ju-Young;Hong, Min-Ho;Koo, Byung-Soo;Kim, Geun-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.30 no.2
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    • pp.89-105
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    • 2019
  • Objectives: We conducted this study to evaluate the efficacy of Chuna Manual Therapy (CMT) for treatment of cervicogenic headache (CeH) through systematic review and Meta-analysis of randomized controlled trials (RCTs) as a preceding research to further research the effective of Chuna Manual Therapy for patients who suffered from CeH. Methods: We conducted a systematic review and meta-analysis by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the studies from MEDLINE, Elsevier-EMBASE, The Cochrane Library, CAJD, KISS, KMBase, Korean Traditional Knowledge Portal, NDSL, and OASIS. The studies selected only in randomized controlled trials. We selected the chosen studies by the selection and the exclusion criteria, and evaluated the quality of the selected studies using the Jadad score and the Cochran ROB tool. We used the Visual Analogue Scale score (VAS) and Clinical total Effective Rate (CER) for the results and analyzed the results of the included studies using RevMan 5.3 software provided by the Cochran library. Results: We included 20 RCTs, including 1,673 subjects, in the systematic review and meta-analysis. After the intervention, the CMT group showed better results than the pharmacotherapy group, the physiotherapy group, and the combined treatment group. The CMT group showed a good effect on the CER and the VAS but showed a significant heterogeneity compared to the pharmacotherapy group. Conclusions: The CMT as monotherapy might have benefits on Cervicogenic Headache patient. Further well-designed studies need to be conducted.

A Case Report of an Epigastralgia Patient using Korean Medicine with Crotonis Fructus Purgation Therapy (파두 공법을 병용한 한방치료로 호전된 위완통 증례보고)

  • Lee, Da-eun;Kim, Dong-hyeon;Noh, Ji-won;Yoo, Jeong-hwa;Ahn, Se-young;Lee, Byung-cheol;Ahn, Young-min
    • The Journal of Internal Korean Medicine
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    • v.39 no.6
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    • pp.1296-1305
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    • 2018
  • A patient with an epigastralgia was treated with Korean medicine for the short-term period of five days under admission care. In this case report, we discuss the efficacy and safety of short-term treatment using Korean medicine methods on a patient with an epigastralgia by evaluating a numerical rating scale, agastrointestinal symptom questionnaire, clinical features, and blood tests. The complex methods comprise purgation therapy using Crotonis Fructus, Korean herbal medication, acupuncture and moxibustion. Throughout the purgation therapy with Crotonis Fructus, the patient reported improvement in both her pain score and dyspepsia index. This case showed that Korean medicine acted not only fast, but also effective for treating epigastralgia patients diagnosed with functional dyspepsia.

Development of a Problem-Based Learning Module for Preschoolers' Growth & Development (학령전기 아동 성장발달의 PBL 모듈 개발)

  • Lee, Myung-Nam;Son, Hae Kyoung
    • The Journal of the Korea Contents Association
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    • v.18 no.11
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    • pp.393-405
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    • 2018
  • Problem-Based Learning (PBL) is a student-centered pedagogy that integrates nursing knowledge, skills, and attitudes into clinical nursing practice. This pilot aims to apply a PBL module on preschoolers' growth and development in the nursing curriculum. This quantitative study was performed to develop a PBL module following Dick and Carye's program development process (planning, development, application, and evaluation phases), and to evaluate its effects using structured questionnaires among sophomore nursing students. These students formed teams of four or five people each and spent 40 minutes participating in the PBL module. Data were analyzed using descriptive statistics, t-tests, and content analysis. Metacognition level increased significantly. There was no significant difference in team efficacy between pre-test and post-test. Post-test learning satisfaction was high. Students reported obtaining knowledge and problem-solving ability with respect to preschoolers' growth and development and were satisfied with teamwork. This finding offers fundamental knowledge concerning the application of a PBL module in nursing curricula.

Evaluation of success criteria for temporomandibular joint arthrocentesis

  • Yilmaz, Onur;Candirli, Celal;Balaban, Emre;Demirkol, Mehmet
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.1
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    • pp.15-20
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    • 2019
  • Objectives: The aim of this study was to use four sets of success criteria to evaluate the outcomes of arthrocentesis treatment with hyaluronic acid injection in patients with internal derangement (ID) of the temporomandibular joint (TMJ). Materials and Methods: The study included 40 patients diagnosed with unilateral Wilkes stage III TMJ dysfunction. Clinical parameters, including maximum mouth opening (MMO) and pain during function, were evaluated preoperatively, 6 months, and 1 year after TMJ arthrocentesis. Outcomes were assessed and compared using four sets of success criteria from the following: the American Association of Oral and Maxillofacial Surgeons (AAOMS; MMO ${\geq}35mm$ and visual analogue scale [VAS] score ${\leq}3$), Murakami et al.'s criteria (MMO >38 mm and VAS score <2), Emshoff and Rudisch criteria (MMO ${\geq}35mm$ and >50% pain reduction), and patient self-reports (self-evaluation of treatment as successful or unsuccessful). Results: Significant improvements in MMO and pain reduction during function were observed between the preoperative period and 6 months and 1 year postoperatively (P<0.01). The success rates of treatment determined using AAOMS (52.5%), Emshoff and Rudisch criteria (57.5%), and self-reported patient criteria (40.0%) were similar. Application of the Murakami et al. criteria reported the lowest success rate (12.5%). Conclusion: The AAOMS and Emshoff and Rudisch criteria are consistent with patient expectations and can be used to assess treatment efficacy.

Efficacy of transforaminal laser annuloplasty versus intradiscal radiofrequency annuloplasty for discogenic low back pain

  • Park, Chan Hong;Lee, Kyoung Kyu;Lee, Sang Ho
    • The Korean Journal of Pain
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    • v.32 no.2
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    • pp.113-119
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    • 2019
  • Background: Discogenic pain is a common cause of disability and is assumed to be a major cause of non-specific low back pain. Various treatment methods have been used for the treatment of discogenic pain. This study was conducted to compare the therapeutic success of radiofrequency (an intradiscal procedure) and laser annuloplasty (both an intradiscal and extradiscal procedure). Methods: This single-center study included 80 patients and followed them for 6 months. Transforaminal laser annuloplasty (TFLA, 37 patients) or intradiscal radiofrequency annuloplasty (IDRA, 43 patients) was performed. The main outcomes included pain scores, determined by the numeric rating scale (NRS), and Oswestry disability index (ODI), at pre-treatment and at post-treatment months 1 and 6. Results: The patients were grouped according to procedure. In all procedures, NRS and ODI scores were significantly decreased over time. Mean post-treatment pain scores at months 1 and 6 were significantly lower (P < 0.01) in both groups, and between-group differences were not significant. The ODI score was also significantly decreased compared with baseline. Among patients undergoing TFLA, 70.3% (n = 26) reported pain relief (NRS scores < 50% of baseline) at post-treatment 6 months, vs. 58.1% (n = 25) of those undergoing IDRA. There were no statistically significant differences between the groups in ODI reduction of > 40%. Conclusions: Our results indicate that annuloplasty is a reasonable treatment option for carefully selected patients with lower back and radicular pain of discogenic origin, and TFLA might be superior to IDRA in patients with discogenic low back pain.

Surgical Ablation of Atrial Fibrillation in Patients Undergoing Bioprosthetic Valve Replacement

  • Pyo, WonKyung;Park, Sung Jun;Kim, Wan Kee;Kim, Ho Jin;Kim, Joon Bum;Jung, Sung-Ho;Joo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won
    • Journal of Chest Surgery
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    • v.52 no.2
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    • pp.61-69
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    • 2019
  • Background: Scarce data have been reported on the efficacy of concomitant atrial fibrillation (AF) ablation in patients undergoing bioprosthetic valve replacement. Methods: From 2001 and 2014, 146 consecutive patients ($69.3{\pm}9.4years$, 84 females) who underwent bioprosthetic heart valve replacement concomitant with AF ablation were assessed. We evaluated long-term rhythm and valve-related outcomes. Results: During 49.1 months of follow-up (interquartile range, 22.5-96.8 months), 7 in-hospital and 49 (6.7% per person-year) post-discharge deaths occurred. The thromboembolic event-free survival rate at 5 years was $79.2%{\pm}3.5%$. The freedom from AF recurrence rate at 5 years was $59.8%{\pm}4.9%$. Multivariate analysis showed that old age (hazard ratio [HR], 1.06; 95% confidence interval [CI], 1.02-1.11; p=0.002), previous cardiac operation (HR, 3.01; 95% CI, 1.22-7.43; p=0.02), and a large left atrial (LA) dimension (HR, 1.02; 95% CI, 1.00-1.05; p=0.045) were significantly associated with AF recurrence. Conclusion: The overall long-term clinical outcomes in these predominantly elderly patients undergoing AF ablation concomitantly with bioprosthetic valve replacement were satisfactory; however, AF recurrence was frequent. Older age, a history of prior cardiac surgery, and large LA size were associated with an increased risk of AF recurrence.

Anti-bacterial effects of lavender and peppermint oils on Streptococcus mutans (Streptococcus mutans 대한 Lavender와 Peppermint Oil의 항균효과)

  • Park, Chung Mu;Yoon, Hyun Seo
    • Journal of Korean Academy of Oral Health
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    • v.42 no.4
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    • pp.210-215
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    • 2018
  • Objectives: The main objectives of this study were to verify the antibacterial activity of two essential oils, lavender and peppermint, against dental caries and to review their synergistic effect when used in combination. Our results provide basic data for the evaluation of the use of these two substances towards the prevention and cure of dental caries. Methods: The sample solutions of lavender and peppermint oils were prepared in three different concentrations (30%, 50%, and 70% (v/v)) by diluting them with third-distilled water and Tween 20. Streptococcus mutans was selected as the bacterial species for testing. The disk diffusion method was used to measure the antibacterial activity of the sample solutions. For generating growth curves and measuring the number of clusters of the bacterial, the liquid medium-dilution method was used; the absorbance of the medium was measured at 600 nm after 3, 6, 12 and 24 hours. Results: When the antibacterial activity of the oils was tested via the disk diffusion method, the activity improved with increasing concentrations of all the sample solutions of peppermint, lavender, and the blend, but there was no significant difference between them with respect to the type of oil. In the growth curves of S. mutans, growth inhibition was observed after 12 hours. The inhibitory effect of 30% lavender oil on growth was 64.9% and 80.1% after 12 and 24 hours of treatment, respectively whereas that of peppermint oil was 71.3% and 80.1% after 12 and 24 hours of treatment, respectively. The inhibitory effect of the blended oil was 71.9% and 81.0% after 12 and 24 hours of treatment, respectively. Conclusions: Further research is still required in order to determine the efficacy of lavender and peppermint oils, as well as other essential oils, for wider use in preventing dental caries.

Long-circulating and target-specific distributions of cyanine 5.5-labeled hyaluronic acid nanoparticles in mouse organs during 28 days after a single administration

  • Yun, Tae Sik;Lin, Chunmei;Yon, Jung-Min;Park, Seul Gi;Gwon, Lee Wha;Lee, Jong-Geol;Baek, In-Jeoung;Nahm, Sang-Seop;Lee, Beom Jun;Yun, Young Won;Nam, Sang-Yoon
    • Korean Journal of Veterinary Research
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    • v.58 no.4
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    • pp.183-192
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    • 2018
  • Although hyaluronic acid (HA) has been developed as a nanoparticle (NP; 320-400 nm) for a drug delivery system, the tissue targeting efficacy and the pharmacokinetics of HA-NPs are not yet fully understood. After a dose of 5 mg/kg of cyanine 5.5-labeled HA-NPs or HA-polymers was intravenously administrated into mice, the fluorescence was measured from 0.5 h to 28 days. The HA-NPs fluorescence was generally stronger than that of HA-polymers, which was maintained at a high level over 7 days in vivo, after which it gradually decreased. Upon ex vivo imaging, liver, spleen, kidney, lung, testis and sublingual gland fluorescences were much higher than that of other organs. The fluorescence of HA-NPs in the liver, spleen and kidney was highest at 30 min, where it was generally maintained until 4 h, while it drastically decreased at 1 day. However, the fluorescence in the liver and spleen increased sharply at 7 days relative to 3 days, then decreased drastically at 14 days. Conversely, the fluorescence of HA-polymers in the lymph node was higher than that of HA-NPs. The results presented herein may have important clinical implications regarding the safety of as self-assembled HA-NPs, which can be widely used in biomedical applications.