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PURPOSE: This retrospective study aimed to identify the factors that affect the duration of thoracodorsal artery perforator (TDAP) free-flap surgery and to offer strategies for optimizing the surgical procedure. METHODS: We analyzed 80 TDAP flap surgeries performed by a single surgeon between January 2020 and December 2022, specifically focusing on free flaps used for lower-extremity defects with single-artery and single-vein anastomosis. The operation duration was defined as the time between the surgeon's initial incision and completion of reconstruction. Linear regression analyses were conducted to identify the factors affecting operation duration. RESULTS: The average operative duration was 149 minutes (range, 80-245 minutes). All flaps survived, although 8 patients experienced partial flap loss. The operative duration decreased with increasing patient age and when end-to-end arterial anastomosis was performed. However, the risk increased with larger flap sizes and in patients with end-stage renal disease. CONCLUSIONS: Our study identified several factors and methods that could accelerate TDAP free-flap procedures. These findings offer valuable insights for optimizing surgical processes and improving overall surgical outcomes. Although further research is needed to confirm and expand upon these findings, our study provides important guidance for surgeons in developing effective strategies for TDAP flap surgery.
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Retalhos de Tecido Biológico , Retalho Perfurante , Procedimentos de Cirurgia Plástica , Humanos , Retalhos de Tecido Biológico/irrigação sanguínea , Estudos Retrospectivos , Retalho Perfurante/irrigação sanguínea , Artérias/cirurgia , Extremidade Inferior/cirurgiaRESUMO
BACKGROUND: We previously reported the mean 6-year outcomes of total hip arthroplasty (THA) using fourth-generation ceramic-on-ceramic (CoC) articulations. With extended observations, this study aimed to report the mean 12-year outcomes focusing on bearing-related complications of CoC THA. METHODS: We reviewed primary CoC THAs performed between May 2009 and April 2012 at a single institution. Of the 831 hips (739 patients), 716 hips (635 patients) that satisfied a minimum 10-year follow-up were included. The mean age at operation was 54 years (range, 16 to 83). The occurrence of bearing-specific complications, including ceramic fractures and noise generation, was evaluated. The mean follow-up duration was 12 years (range, 10 to 14). RESULTS: A total of 2 (0.3%) ceramic liner fractures occurred, as previously reported. No additional ceramic fractures were observed during the extended follow-up period. However, the cumulative incidence of audible noise increased from 6.4 (48 of 749) to 8.2% (59 of 716). Of the 59 hips with noise, 26 (44.1%) developed noise within 1 year, whereas 13 (22.0%) presented with noise more than 5 years after THA. The noise was described as clicking in 35 hips (4.9%) and as squeaking in 24 hips (3.4%). No revision surgeries were performed for noise, except in 2 cases of concomitant liner fractures. The implant survivorship free of any revision was 98.1% at 12 years. CONCLUSIONS: No additional ceramic fractures were identified in this extension study at a minimum follow-up of 10 years. However, the prevalence of articular noise has increased from 6.4 to 8.2% since the previous report. Possible late-onset noise should be considered when performing CoC THA in younger patients.
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Fenbendazole (FBZ) has been safely used as an antiparasitic agent in animals for decades, and the anticancer effects of FBZ have been studied through various mechanisms. However, there is a lack of in vivo studies that include lymphoma. Therefore, this study examined the effects of FBZ on EL-4 cells and a mouse T lymphoma model. FBZ induced G2/M phase arrest in EL-4 cells, resulting in cell death and decreased metabolic activity. However, FBZ had no anticancer effects on an EL-4 mouse lymphoma model in vivo, as evident by rapid weight loss and tumor growth comparable to the control. The FBZ-treated EL-4 cells expressed higher levels of PD-L1 and CD86, which are associated with T cell immunity in the tumor microenvironment (TME), than the controls. Furthermore, the hematoxylin and eosin staining of the FBZ-treated tumor tissues showed a starry sky pattern, which is seen in actively proliferating cancer tissues, and an immunohistochemical analysis revealed a high percentage of immunosuppressive M2 macrophages. These changes in the immune activity in the TME contradict the results of the in vitro experiments, and further studies are needed to determine the detailed mechanisms by which FBZ induces these responses.
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Zinc is a trace metal vital for various functions in nerve cells, although the effect of zinc deficiency on neuronal autophagy remains unclear. This study aimed to elucidate whether zinc deficiency induced by treatment with N, N, N', N'-tetrakis (2-pyridylmethyl) ethylenediamine (TPEN), a zinc chelator, affects and alters autophagy activity. In cell viability assays, TPEN showed cytotoxicity in HT-22 cells. TPEN treatment also increased LC3-II levels and the ratio of LC3-II to LC3-I. Western blot analysis showed that phospho-AMP-activated protein kinase levels and the ratio of phospho-AMP-activated protein kinase to total AMP-activated protein kinase increased. Protein levels of the mammalian target of rapamycin and sirtuin 1 decreased following TPEN treatment. When TPEN-treated HT-22 cells were cotreated with autophagy inhibitors, 3-methyladenine (1 mM), or bafilomycin A1 (3 nM), the TPEN-induced decrease in cell viability was exacerbated. Cotreatment with chloroquine (10 µM) partially restored cell viability. The study showed that zinc deficiency induces autophagy and may be cytoprotective in neurons. We expect our results to add a new perspective to our understanding of the neuronal pathology related to zinc deficiency.
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Proteínas Quinases Ativadas por AMP , Autofagia , Proteínas Quinases Ativadas por AMP/metabolismo , Animais , Linhagem Celular , Quelantes/farmacologia , Etilenodiaminas/farmacologia , Hipocampo/metabolismo , Mamíferos/metabolismo , Camundongos , Neurônios/metabolismo , Zinco/metabolismoRESUMO
This study investigated the use of basil seed gum (BSG) as a fat substitute on the physicochemical properties and antioxidant activities of yogurt. A 0.5 and 1% BSG solution was supplemented to reduced-fat and nonfat yogurts, and their physicochemical properties, quality properties, antioxidant activity, and sensory evaluation were compared with each control group. We prepared 3 yogurts as controls and 4 yogurt samples containing BSG as follows: FFY (yogurt made from full-fat milk: a control group), LFY (yogurt made from reduced-fat milk: a control group), SY (yogurt made from nonfat milk: a control group), LFY 0.5% (0.5% BSG added to reduced-fat yogurt), LFY 1.0% (1.0% BSG added to reduced-fat yogurt), SY 0.5% (0.5% BSG added to nonfat yogurt), and SY 1.0% (1.0% BSG added to nonfat yogurt). The pH of LFY 0.5% and LFY 1.0% was decreased compared with LFY control, whereas pH of SY 0.5% and SY 1.0% had no significant difference. The titratable acidity showed no significant increase. The viscosity was the highest in FFY among the control groups and increased with the concentration of BSG in the SY group. The L-value (brightness) and b-value (yellowness) were the highest in FFY at 85.05 among the control groups. The L-value and b-value of LFY 0.5% and SY 0.5% showed higher values than LFY 1% and SY 1%. The a-value (redness) was the highest in SY 0.5% at -2.36, and ΔE (total color difference) was the highest in SY 1% at 7.33. The moisture content of SY was the highest among the control groups and addition of 1% BSG to SY was highest among the BSG-added group. Total contents of phenol and flavonoid slightly increased as the concentration of BSG increased (increase in the contents of phenol and flavonoid). The results of ferric reducing antioxidant power were similar to the findings of phenol and flavonoid content (an increase as the concentration of BSG increased). The overall acceptability of sensory characteristics was improved in all groups of samples when BSG 1% concentration increased. Application of BSG for the production of nonfat yogurt can enhance physicochemical properties, antioxidant activity, and sensory characteristics of reduced-fat and nonfat yogurt. Addition of BSG to reduced-fat and nonfat yogurt can improve their physical and antioxidant properties to the level of FFY.
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Antioxidantes/metabolismo , Suplementos Nutricionais/análise , Substitutos da Gordura/análise , Leite/química , Ocimum basilicum/química , Iogurte/análise , Animais , Manipulação de Alimentos/métodos , Proteínas do Leite/análise , Sementes/química , Paladar , ViscosidadeRESUMO
BACKGROUND: Almost half of mild cognitive impairment (MCI) patients progress to dementia, which is associated with decreased quality of life and obstacles to independent living. Relevant management is expected to prevent MCI patients from progressing to dementia. In recent years, electroacupuncture (EA) has been used to treat various kinds of neurological disorders including MCI. This study evaluates the use of EA for MCI patients to increase cognitive function through a comparison with Western medications. METHODS: Randomized controlled trials (RCT) or systematical reviews (SR) of EA versus Western medications for MCI were searched using the following 10 databases: Pubmed, Cochrane Library, CINAHL, EMBASE, China National Knowledge Infrastructure (CNKI), National Digital Science Library (NDSL), Journal of Oriental Neuropsychiatry (JON), Korean Medical Database (KMBASE), KoreaMed, and OASIS, from October 2007 to August 2017, without language restriction. A methodological quality assessment of RCTs or SRs that met inclusion criteria was conducted using Cochrane Risk of bias (RoB) tool and a meta-analysis by RevMan (Review Manager) 5.3.5 version of Cochrane collaboration. RESULTS: Five RCTs with 257 patients met inclusion criteria and those were randomly divided into two groups: the EA group (n = 103) and Western medications group (n = 154). The methodological quality of the included studies showed high risk or/and unclear of risk of bias. The meta-analysis of five studies reported that the EA group was better than the Western medications group, improving the Mini Mental State Examination (MMSE) score by 0.65 [95% CI 0.28~1.01] higher mean difference, Montreal Cognitive Assessment (MoCA) score by 0.66 [95% CI 0.00~1.32] higher mean difference. Adverse effects were not reported in the selected studies. CONCLUSION: Electroacupuncture was an effective treatment for MCI patients by improving cognitive function. However, the included studies presented a low methodological quality and no adverse effects were reported. Thus, further comprehensive studies with a design in depth are needed to derive significant results.
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Disfunção Cognitiva/terapia , Eletroacupuntura , Nootrópicos/uso terapêutico , Disfunção Cognitiva/tratamento farmacológico , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do TratamentoRESUMO
This study tested key tenets of objectification theory with South Korean women and explored the roles of sexually objectifying media and culture-specific standards of beauty in body image and eating disorder symptoms. Two pilot studies with South Korean college women (n = 40, n = 30) revealed that facial characteristics such as size and shape represent a discrete variable among culture-specific standards of beauty for South Korean women. Results with a sample of 562 South Korean college women indicated that media exposure had significant positive indirect relations with body shame and eating disorder symptoms through the mediating roles of internalization, body surveillance, and face surveillance. Internalization of cultural standards of beauty had significant positive direct relations with body surveillance and face surveillance and had both direct and indirect relations with body shame and eating disorder symptoms. Body and face surveillances had significant positive direct relations with body shame and had indirect relations with eating disorder symptoms. Finally, body shame mediated the links from internalization and surveillance variables to eating disorder symptoms. The results support the applicability of objectification theory as it relates to South Korean women and point to the significance of culture-specific standards of beauty within that framework. These findings could contribute to the broader field of multicultural body image research, with potential implications for therapist practices and training. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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Povo Asiático/psicologia , Imagem Corporal , Características Culturais , Transtornos da Alimentação e da Ingestão de Alimentos/etnologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Identidade de Gênero , Meios de Comunicação de Massa , Teoria Psicológica , Valores Sociais , Adulto , Beleza , Transtornos Dismórficos Corporais/etnologia , Transtornos Dismórficos Corporais/psicologia , Índice de Massa Corporal , Face , Feminino , Humanos , Controle Interno-Externo , Determinação da Personalidade/estatística & dados numéricos , Projetos Piloto , Psicometria , Vergonha , Conformidade Social , Adulto JovemRESUMO
BACKGROUND: Adjusting the direction of the anterolateral ligament (ALL) femoral tunnel is suggested to avoid tunnel convergence during anterior cruciate ligament (ACL) reconstruction. Yet, there has been no in vivo clinical study reporting the effect of changing the direction of the ALL tunnel on the incidence of convergence with the ACL tunnel. PURPOSE: To report the incidence of convergence between the ACL femoral tunnel and a distally and anteriorly directed ALL femoral tunnel and to determine a safe distal angle and anterior angle. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: A total of 227 patients undergoing concomitant ALL and anatomic single-bundle ACL reconstruction between January 2020 and December 2022 were retrospectively reviewed. The tunnel convergence rate, angular orientation of the tunnels, and distance between tunnels were obtained using postoperative computed tomography. The patients were grouped based on the direction of the ALL tunnel (transverse vs distal anterior) and the presence of tunnel convergence (convergence vs no convergence). RESULTS: The overall tunnel convergence rate was 53.3% (121/227 patients). Tunnel convergence was observed less frequently in the distal anterior group (33.7%) than in the transverse group (65.2%) (P < .001). The no convergence group showed an ALL tunnel oriented more distally (20.2°± 11.1°) and anteriorly (19.5°± 10.2°) compared with the convergence group (8.7°± 6.5° and 6.9°± 5.3°, respectively) (P = .005 and P = .008, respectively). There were no cases of tunnel convergence for ALL tunnels >24.3° distally and >25.5° anteriorly. There was no difference in the angle of the ACL femoral tunnel between all groups. CONCLUSION: A distally and anteriorly directed ALL femoral tunnel reduced the incidence of convergence with the ACL femoral tunnel. A distal angle >24.3° and an anterior angle >25.5° of an ALL tunnel are suggested to safely avoid convergence with the ACL tunnel.
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Lesões do Ligamento Cruzado Anterior , Articulação do Joelho , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Incidência , Estudos Retrospectivos , Estudos Transversais , Ligamento Cruzado Anterior/diagnóstico por imagem , Ligamento Cruzado Anterior/cirurgia , Tomografia Computadorizada por Raios X/métodos , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Lesões do Ligamento Cruzado Anterior/diagnóstico por imagem , Lesões do Ligamento Cruzado Anterior/epidemiologia , Lesões do Ligamento Cruzado Anterior/cirurgiaRESUMO
This study applied pulsed electric fields (PEFs) to accelerate the withering and drying processes during cold-brewed black tea production. PEF pretreatment was administered at 1.0, 1.5, and 2.0 kV/cm electric field strengths, combined with varying withering times from 8 to 12 hr. During the 12-hour withering process, the redness value (a*) and total color change (∆E) of PEF-treated leaves significantly increased (p < 0.05). Furthermore, the homogenous redness of tea leaves during fermentation depended on the PEF strength applied. In addition, PEF pretreatment remarkably reduced the drying time, up to a 50% reduction at a 2.0 kV/cm field strength. Additionally, the 2.0 kV/cm PEF-pretreated black tea exhibited a notable 42% increase in theaflavin (TF) content and a 54% increase in thearubigin (TR) content. Sensory evaluation scores were highest for black tea that received PEF pretreatment at 2.0 kV/cm. These findings highlight the significant potential of PEFs in enhancing the efficiency of withering and drying processes while positively impacting the physicochemical and sensory properties of cold-brewed black tea.
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This study aimed to investigate the effects of jet-milling on the lutein extraction contents of spinach powder (SP), as well as the effects of pulsed electric field (PEF), as a non-thermal pasteurization technology, on the preservation of spinach juice (SJ) lutein contents. SP particles were divided into SP-coarse (Dv50 = 315.2 µm), SP-fine (Dv50 = 125.20 µm), and SP-superfine (Dv50 = 5.59 µm) fractions, and SP-superfine was added to SJ due to its having the highest contents of lutein extract. PEFs and thermal treatment were applied to evaluate the effects of preserving the lutein content of PEF during storage (25 days). The juice was then designated as untreated (no pasteurization), PEF-1,2 (SJ treated with PEF 20 kV/cm 110 kJ/L, 150 kJ/L), or Thermal-1,2 (SJ treated with 90 °C, 10 min and 121 °C, 15 min). The sizes and surface shapes of the superfine SP particles were more homogeneous and smoother than those of the other samples. SJ made with SP-superfine and treated with PEF had the highest lutein content and antioxidant activities among the group during storage. A complex of jet-milling and PEF could have great potential as a method to improve the lutein contents of lutein-enriched juice in the food industry.
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Conventional treatments for allergic rhinitis (AR) exhibit insufficiency and long-term use-related side effects. Considering the reported anti-inflammatory and immunoregulatory effects of Bojungikgi-tang (BJIGT), we aimed to assess its efficacy on persistent AR (PAR). Patients with PAR were randomly assigned in a 1:1:1 ratio into high-dose BJIGT, standard-dose BJIGT, and placebo groups, followed by 1-week run-in and 4-week treatment periods. The primary outcome included the mean change in Total Nasal Symptom Score (TNSS), with secondary outcomes encompassing the Korean Allergic Rhinitis-Specific Quality of Life Questionnaire, biomarkers, overall assessment, TNSS by AR pattern identification, and the Sasang constitution. The mean TNSS change was more improved in the BJIGT group than in the placebo group; however, no statistically significant differences were observed. Additional interaction effect analysis revealed a statistically significant improvement in the high-dose BJIGT group compared with the placebo group from weeks 1-2 to weeks 3-4. Regarding secondary outcomes, the BJIGT group exhibited similar or improved results compared with the placebo group, showing no statistically significant differences. No serious adverse effects or clinically significant changes in safety assessments were observed. Given that this study validated clinical improvement and safety, it serves as potential groundwork for pertinent future studies.
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This study aimed to investigate and optimize the quality and sensory properties of baked products with lutein-enriched marigold flower powder (MP). Lutein-enriched marigold flowers produced via hydroponic methods using LED lights were used as a functional material in sponge cakes to increase lutein content. MP particles were divided into coarse (Dv50 = 315 µm), fine (Dv50 = 119 µm), and superfine MP (Dv50 = 10 µm) fractions and added to the sponge cake after being designated to control (sponge cake prepared without MP), coarse MPS (sponge cake prepared with coarse MP), fine MPS (sponge cake prepared with fine MP), and superfine MPS (sponge cake prepared with superfine MP) groups. The sizes and surface properties of superfine MP particles were more homogeneous and smoother than the other samples. As the particle size decreased, the specific volume increased, whereas baking loss, hardness, and chewiness of the sponge cake decreased. Superfine MP and superfine MPS had the highest lutein content. The flavor of marigold and the overall acceptability of sponge cake with superfine MP were 7.90 ± 0.97 and 7.55 ± 0.76, which represents the highest values among the samples. The results of this study have shown that jet milling can contribute to improvements in texture, lutein content, and sensory qualities for baked products with MP.
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The pulsed electric field (PEF) is a non-thermal food processing technology that induces electroporation of the cell membrane thus improving mass transfer through the cell membrane. In this study, the drying and rehydration kinetics, microstructure, and carotenoid content of carrot (Daucus carota) pretreated by PEF during convective drying at 50 °C were investigated. The PEF treatment was conducted with different field strengths (1.0-2.5 kV/cm) using a fixed pulse width of 20 µs and at a pulse frequency of 50 Hz. The PEF 2.5 kV/cm showed the shortest drying time, taking 180 min, whereas the control required 330 min for the same moisture ratio, indicating a 45% reduction in drying time. The rehydration ability also increased as the strengths of PEF increased. PEF 2.5 kV/cm resulted in 27.58% increase in moisture content compared to the control after rehydration (1 h). Three mathematical models were applied to the drying and rehydration data; the Page and Peleg models were selected as the most appropriate models to describe the drying and rehydration kinetics, respectively. The cutting force of the sample was decreased as the strength of PEF increased, and a more homogeneous cellular structure was observed in the PEF pretreatment group. The reduction in drying time by PEF was beneficial to the carotenoid content, and PEF 2.5 kV/cm showed the highest preservation content of carotenoid. Overall, these results suggested that the pretreatment of PEF and the drying and rehydration rate influence the quality of products, functional components, and cellular structure.
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BACKGROUND: Cough-variant asthma (CVA), a precursor of typical asthma, is the main cause of chronic cough. We hypothesize that yukmijihwang-tang (YJT), which has been used for chronic cough in traditional medicine and has been reported to have an anti-inflammatory effect, could be an adjuvant to asthma treatment. METHODS: We plan a randomized, double-blind, placebo-controlled, multicenter, phase 2 trial to investigate the efficacy and safety of YJT in CVA patients. A total of 60 patients with CVA will be recruited and randomly assigned to either a high-dose YJT group, standard-dose YJT group, or control group (placebo) in a 1:1:1 allocation ratio after a 2-week run-in period. For the run-in period, only inhaled corticosteroids (ICSs) will be used, and the investigational drug will be administered once a day with concomitant ICS for 6 weeks. Data will be collected at baseline, week 3, and week 6, and the primary outcome measure will be the mean cough symptom score (CSS) change before and after medication. The secondary outcome measures will include the Leicester cough questionnaire-Korean version (LCQ-K) score, eosinophil count and eosinophil cationic protein level, pulmonary function test, and the number of uses of rescue medication, and so on. CONCLUSION: This study aimed to evaluate the efficacy and safety of YJT in concomitant treatment with ICS in patients with CVA and to determine the optimal dosage of YJT. The results are expected to provide evidence for the use of YJT as an adjuvant treatment for CVA.
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Asma , Tosse , Humanos , Tosse/tratamento farmacológico , Asma/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Multicêntricos como Assunto , Ensaios Clínicos Fase II como AssuntoRESUMO
Objectives: This study aimed to evaluate the clinical efficacy and safety of PE extracts developed for the purpose of relieving pain and improving knee joint function on semi-healthy people with mild knee joint pain. Methods: A randomized, double-blind, two-arm, single-center, placebo-controlled clinical trial was conducted. Individuals with knee joint pain and a visual analogue scale (VAS) score < 50 mm were included in the study, and participants with radiological arthritis were excluded. Participants were administered either PFE or a placebo capsule (700 mg, twice a day) orally for eight weeks. The comparisons of the changed VAS score and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scores between the PFE and placebo groups were primary outcomes, while the five inflammation-related laboratory tests including cartilage oligomeric matrix protein, cyclooxygenase-2, neutrophil and lymphocyte ratio, high sensitive C-reactive protein, and erythrocyte sedimentation rate were secondary outcomes. Also, a safety assessment was done. Results: Eighty participants (mean age, 38.4 ± 14.0, male: female, 28:52) were enrolled; 75 completed the trial (PFE 36 and placebo 39). After eight weeks, both VAS and WOMAC scores were reduced in the PFE and placebo groups. The changed scores were significantly higher in the PFE group compared to the placebo group: 19.6 ± 10.9 vs. 6.8 ± 10.5; VAS scores (p < 0.001), and 20.5 ± 14.7 vs. 9.3 ± 16.5; total WOMAC scores (p < 0.01) including the sub-scores for pain, stiffness, and functions. No significant changes were reported in the five inflammation-related laboratory parameters. All adverse events were considered minor and unlikely to result from the intervention. Conclusion: Eight weeks of PFE intake was more effective than placebo in reducing knee joint pain and improving knee joint function in sub-healthy people with mild knee joint pain, and there were no major safety concerns. Clinical Trial Registration: https://cris.nih.go.kr/cris/search/detailSearch.do?search_lang=E&focus=reset_12&search_page=M&pageSize=10&page=undefined&seq=23101&status=5&seq_group=19745, identifier CRIS: KCT0007219.
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The global coronavirus disease 2019 (COVID-19) pandemic spurred an urgent need for vaccination and herd immunity. Recently, mRNA vaccines for COVID-19 have been used widely despite reports of several adverse events. Most adverse effects are mild, although a few are associated with neurological complications. Unfortunately, there is a scarcity of information on peripheral nerve complications after COVID-19 mRNA vaccination. We report the case of an immunocompetent young male patient who suffered from ipsilateral wrist drop with multiple lymphadenopathy in the cervical and axillary region after Pfizer-BioNTech vaccination. He experienced unilateral wrist drop, which significantly improved with corticosteroid treatment. Based on knowledge of this adverse effect, careful surveillance and increased awareness are needed for early diagnosis. To the best of our knowledge, this is the first reported case in the English literature of radial neuropathy resulting in wrist drop in a recently vaccinated and young immunocompetent patient.
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Vacinas contra COVID-19 , COVID-19 , Neuropatia Radial , Vacinas contra COVID-19/efeitos adversos , Humanos , Masculino , RNA Mensageiro , Neuropatia Radial/etiologia , VacinaçãoRESUMO
BACKGROUND: Pulmonary rehabilitation (PR) is a management modality that improves the quality of life of patients with chronic obstructive pulmonary disease (COPD); however, PR is not readily accessible. Therefore, we developed lung-conduction exercises (LCE) that can be performed easily without any limitations. The purpose of this randomized, assessor-blind, multicenter pilot trial was to compare the effects of LCE with PR and standard care (SC) in COPD patients. METHODS: Twenty-five participants who met the eligibility criteria were randomly allocated to the SC group (only medication, nâ=â9), LCE group (medication + LCE, 5 times a week, nâ=â8), or PR group (medication + PR, 5 times a week, nâ=â8). The 6-minute walk distance (6WMD), pulmonary function test, modified Medical Research Council dyspnea scale, COPD assessment test (CAT), and St. George Respiratory Questionnaire (SGRQ) survey were carried out before starting the trial and after 4 and 8âweeks to determine motor performance, lung function, and dyspnea. RESULTS: After 8âweeks, the pulmonary function test scores were the same. The 6MWD (PR, 28.3â±â38.5; LCE, 14.5â±â53.1; SC, 11.5â±â20.5; Pâ=â.984), modified Medical Research Council dyspnea scale (PR, 0.8â±â1.0; LCE, 0.8â±â0.8; SC, 0.3â±â0.5; Pâ=â.772), CAT (PR, 7.3â±â6.2; LCE, 4.2â±â5.2; SC, 1.0â±â2.2; Pâ=â.232), and SGRQ scores (PR, 11.5â±â15.4; LCE, 5.5â±â13.1; SC, 4.8â±â5.1; Pâ=â.358 [PR vs LCE], Pâ=â.795 [PR vs SC]) had improved in order of PR, LCE, and SC group. Although there were no statistically significant differences in the outcome measures between the groups, there were clinically significant improvements in the CAT and SGRQ scores. CONCLUSIONS: In this trial, PR showed more improvement in symptoms and quality of life than SC alone. To seek a more precise use of LCE, further full-sized studies with a long duration and additional outcome measures such as psychological assessment tools and cost-effectiveness ratio should be conducted. TRIAL REGISTRATION: KCT0004724.
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Exercícios Respiratórios/métodos , Dispneia/etiologia , Terapia por Exercício/métodos , Doença Pulmonar Obstrutiva Crônica/terapia , Terapia Respiratória/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Dispneia/terapia , Tolerância ao Exercício , Feminino , Humanos , Pulmão , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Qualidade de Vida , Testes de Função Respiratória , Inquéritos e Questionários , Resultado do TratamentoRESUMO
Background: Obstructive airway disease is a major health problem and has a great impact on global socioeconomic burden. Despite therapeutic advances in recent decades, there is still a need for effective and safe therapeutic agents for patients with asthma or chronic obstructive pulmonary disease (COPD). Methods: This prospective observational study explored the effects of herbal medicines in patients with asthma and COPD. All participants visited the hospital at least every 4 weeks for 12 weeks to receive their herbal medicines based on their pattern identification and to evaluate safety and efficacy endpoints. We followed the diagnostic criteria used by Korean medicine doctors to prescribe herbal medicines, explored variations in prescribed herbal medicines, and explored a number of clinical features in patients with asthma or COPD. Results: A total of 24 patients were enrolled: 14 were diagnosed with asthma and 10 with COPD and 19 completed the study. After 12 weeks of herbal medicine treatment, herbal medicines significantly improved the modified Clinical Asthma Measurement Scale in Oriental Medicine-V in asthma patients and the modified Medical Research Council Dyspnoea Scale and St. George's Respiratory Questionnaire in COPD patients. For all patients, modified Medical Research Council Dyspnoea Scale score and interleukin-13 were found to be significantly different after treatment. Additionally, the majority of patients were satisfied with our herbal medicine treatments, and no severe adverse events were reported during the study. Conclusions: Our study provides preliminary clinical data on the safety and efficacy of herbal medicines in patients with asthma and COPD.
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Background: Allergic rhinitis (AR) is a common disease, and conventional medications are often insufficient for treatment. Bojungikgi-tang (BJIGT) is an herbal medicine widely used in traditional medicine and has anti-inflammatory and immunoregulatory effects. We hypothesize that BJIGT would improve nasal symptoms in patients with persistent AR (PAR). Methods: This is a randomized, double-blind, placebo-controlled, phase II trial. A total of 105 patients, identified with perennial allergens, with a history of PAR and a mean total nasal symptom score (TNSS) ≥ 5 during the run-in period will be recruited from Daejeon Korean Medicine Hospital. Participants will be randomly assigned to a high-dose BJIGT group, standard-dose BJIGT group, or control group (placebo) in a 1 : 1 : 1 allocation ratio after a week run-in period. The treatment medication will be taken three times per day for 4 weeks. The primary outcome measure is the mean change in the TNSS before and after medication. The secondary outcome measures include the Korean Allergic Rhinitis-Specific Quality of Life Questionnaire, total IgE and eosinophil count, overall assessment of AR, pattern identification questionnaire for AR, and Sasang constitution. Discussion. The aim of this study is to investigate the efficacy and safety of BJIGT in the treatment of PAR and to determine the suitable dosage of BJIGT. Therefore, we planned a randomized, controlled, phase II trial of two different doses of BJIGT compared with placebo, and the results of this study are expected to provide evidence for the use of BJIGT as a treatment of PAR. Trial Registration. The National Clinical Trial Registry Clinical Research Information Service, CRIS, KCT0006616, https://cris.nih.go.kr/cris/search/detailSearch.do/20706.
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INTRODUCTION: Wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) is a rare variation of internuclear ophthalmoplegia associated with bilateral lesions of the medial longitudinal fasciculus. CASE REPORT: In this case, the edematous lesions of the ipsilateral midbrain infarction appeared to compress the contralateral medial longitudinal fasciculus, resulting in WEBINO. Treatment of focal cerebral edema caused by ischemic stroke is still under debate. However, in this case, antiedema treatment was implemented to prevent the sequelae of the edematous lesion caused by a midbrain infarction, and a relatively rapid improvement of ocular symptoms was observed. CONCLUSION: Herein, we report a rare case of WEBINO caused by a unilateral midbrain infarction in which the patient experienced edema-related neurological deficits. This case provides evidence that early antiedema therapy may benefit patients with similar presentations.