By means of searching the ancient and modern literature,this study mainly investigated the etiology and pathogenesis of IBD,summarized the rules of acupoint selection and the experimental mechanism of the moxibustion treatment for IBD,providing the basis and theoretical evidence of acupoint selection and moxibustion therapy for clinical practice and studies.Ancient literatures were retrieved in TCM database system,while modern literatures in Pubmed,CNKI and VIP database from January,2005 to January,2016.Finally,comprehensive analysis was implemented among the selected literatures.It was found that the pathogenesis of IBD was associated with exogenous evils,diet,emotion,and fatigue during chronic diseases in TCM.The treatments of acupuncture and moxibustion for IBD should consider both the primary symptoms and root causes by regulating functional activity of Zang and Fu and also warming and nourishing the spleen and stomach.On this basis,acupoint selection mainly focused on the stomach meridian with the functions of invigorating spleen and stomach,elevating clear qi and descending turbid,recovering the bowel function and strenthening the body and antidiarrhea.Modern research upon the scientific basis of TCM indicated that moxibustion stimulated the thermoreceptors around the acupoints leading to the increased degranulation of mast cells.Immune factors were impacted with the regulation of transcriptional activators in the bowel for repairing mucosal barrier and preventing intestinal fibrosis in IBD.In conclusion,moxibustion was effective on warming and nourishing spleen and stomach and regulating the function activity of bowel for the prevention and treatment of IBD.Achievements were made in the mechanism researches on IBD based on the TCM theory.However,some profound mechanisms need in-depth exploring.

Objective:To assess the effects of direct moxibustion on 24-hour ambulatory blood pressure (ABP) and clinical symptoms of traditional Chinese medicine (TCM) in elderly patients with essential hypertension, and to explore the antihypertensive effect and influencing factors of moxibustion. Methods:A total of 101 elderly hypertension patients who met the inclusion criteria were randomly assigned to a direct moxibustion I group (n=33), a direct moxibustion II group (n=34), and a control group (n=34). The treatment of calcium antagonist (CCB) orangiotensin II receptor antagonist (ARB) was adopted in the control group. The treatment of direct moxibustion I plus the same medicine as the control group were adopted in the direct moxibustion I group, five cones per acupoint and three times per week, for 5 weeks in total. The treatment of direct moxibustion II plus the same medicine as the control groupwere adopted in the direct moxibustion II group, five cones per acupoint and three times per week, for 5 weeks in total. The changes of 24-hour ABP and clinical symptoms of TCM after treatment were compared in the three groups. Results: The mean 24-hour ambulatory systolic blood pressure (mean 24 h ASBP), night ASBP, percentage of mean 24-hour ambulatory diastolic blood pressure (mean 24 h ADBP)>90 mmHg, and percentage of day ADBP>90 mmHg in the control group were elevated after treatment (P<0.05). The percentage of night ADBP>80 mmHg in the direct moxibustion I group was reduced by treatment (P<0.01). There were no significant differences in the other outcome measures of 24 h ABP, such as day ASBP, percentage of mean 24 h ASBP>140 mmHg, percentage of day ASBP>140 mmHg, percentage of night ASBP>120 mmHg , mean 24 h ADBP, day ADBP, night ADBP, 24 h ambulatory pulse pressure (APP), after treatment in all groups (P>0.05). The degree of improvement of the clinical symptoms of TCM showed significant differences among the three groups of patients (P<0.01). The total effective rate in the direct moxibustion I group was 73.3%, which was superior to those in the direct moxibustion II group and control group (13.3% and 10.0%, respectively). Conclusion:The direct moxibustion has benign regulative effect on blood pressure of elderly patients with essential hypertension, and improves their clinical symptoms. The direct moxibustion method I (burning the next moxa cone after the previous one had totally burnt out) was superior to method II (burning the next moxa cone when the previous one had not totally burnt out ) in lowering blood pressure and improving symptoms of elderly patients with essential hypertension.

Purpose: The authors aimed to identify the factors affecting interhospital transfer (“transfer”) of severe pediatric patients who visited to an emergency department (ED). Methods: Using the Korean National ED Information System, we analyzed high-acuity patients aged 18 years or younger who visited EDs of local or regional emergency centers nationwide. The high acuity was defined as a Korean Triage and Acuity Scale 1-2. To investigate the factors associated with transfer, a multilevel modeling was selected, examining independent variables at both individual- and hospital-levels with transfer as a dependent variable. Results: A model consisting of variables at individual- and hospital-levels showed the factors as follows: mode of arrival(self-transport: odds ratio, 0.48 [95% confidence interval, 0.38-0.61]; other ambulances: 0.41 [0.24-0.71]; compared with firehouse ambulance), visit at 18:00-07:59 (0.75 [0.64-0.88]), intentional injury (1.59 [1.03-2.47]; compared with non-injury), decreased level of consciousness (drowsy: 1.94 [1.33-2.84]; stupor: 4.08 [2.99-5.57]; coma: 1.81 [1.26-2.60]; compared with alert), severe illness diagnosis (1.49 [1.12-1.98]), the number of all beds in EDs (1.02 [1.01-1.04]), and acceptance for treatment (0.92 [0.87-0.98]; with increment of 1%). Conclusion This study confirms that both individual-level and hospital-level factors affect the transfer risk of severe pediatric patients in EDs. The study suggests the needs for direct transportation to specialized pediatric treatment facilities, and concentrated support for the pediatric emergency medical centers and pediatric trauma centers.

Purpose: The authors aimed to identify the factors affecting interhospital transfer (“transfer”) of severe pediatric patients who visited to an emergency department (ED). Methods: Using the Korean National ED Information System, we analyzed high-acuity patients aged 18 years or younger who visited EDs of local or regional emergency centers nationwide. The high acuity was defined as a Korean Triage and Acuity Scale 1-2. To investigate the factors associated with transfer, a multilevel modeling was selected, examining independent variables at both individual- and hospital-levels with transfer as a dependent variable. Results: A model consisting of variables at individual- and hospital-levels showed the factors as follows: mode of arrival(self-transport: odds ratio, 0.48 [95% confidence interval, 0.38-0.61]; other ambulances: 0.41 [0.24-0.71]; compared with firehouse ambulance), visit at 18:00-07:59 (0.75 [0.64-0.88]), intentional injury (1.59 [1.03-2.47]; compared with non-injury), decreased level of consciousness (drowsy: 1.94 [1.33-2.84]; stupor: 4.08 [2.99-5.57]; coma: 1.81 [1.26-2.60]; compared with alert), severe illness diagnosis (1.49 [1.12-1.98]), the number of all beds in EDs (1.02 [1.01-1.04]), and acceptance for treatment (0.92 [0.87-0.98]; with increment of 1%). Conclusion This study confirms that both individual-level and hospital-level factors affect the transfer risk of severe pediatric patients in EDs. The study suggests the needs for direct transportation to specialized pediatric treatment facilities, and concentrated support for the pediatric emergency medical centers and pediatric trauma centers.

Purpose: The authors aimed to identify the factors affecting interhospital transfer (“transfer”) of severe pediatric patients who visited to an emergency department (ED). Methods: Using the Korean National ED Information System, we analyzed high-acuity patients aged 18 years or younger who visited EDs of local or regional emergency centers nationwide. The high acuity was defined as a Korean Triage and Acuity Scale 1-2. To investigate the factors associated with transfer, a multilevel modeling was selected, examining independent variables at both individual- and hospital-levels with transfer as a dependent variable. Results: A model consisting of variables at individual- and hospital-levels showed the factors as follows: mode of arrival(self-transport: odds ratio, 0.48 [95% confidence interval, 0.38-0.61]; other ambulances: 0.41 [0.24-0.71]; compared with firehouse ambulance), visit at 18:00-07:59 (0.75 [0.64-0.88]), intentional injury (1.59 [1.03-2.47]; compared with non-injury), decreased level of consciousness (drowsy: 1.94 [1.33-2.84]; stupor: 4.08 [2.99-5.57]; coma: 1.81 [1.26-2.60]; compared with alert), severe illness diagnosis (1.49 [1.12-1.98]), the number of all beds in EDs (1.02 [1.01-1.04]), and acceptance for treatment (0.92 [0.87-0.98]; with increment of 1%). Conclusion This study confirms that both individual-level and hospital-level factors affect the transfer risk of severe pediatric patients in EDs. The study suggests the needs for direct transportation to specialized pediatric treatment facilities, and concentrated support for the pediatric emergency medical centers and pediatric trauma centers.

Purpose: The authors aimed to identify the factors affecting interhospital transfer (“transfer”) of severe pediatric patients who visited to an emergency department (ED). Methods: Using the Korean National ED Information System, we analyzed high-acuity patients aged 18 years or younger who visited EDs of local or regional emergency centers nationwide. The high acuity was defined as a Korean Triage and Acuity Scale 1-2. To investigate the factors associated with transfer, a multilevel modeling was selected, examining independent variables at both individual- and hospital-levels with transfer as a dependent variable. Results: A model consisting of variables at individual- and hospital-levels showed the factors as follows: mode of arrival(self-transport: odds ratio, 0.48 [95% confidence interval, 0.38-0.61]; other ambulances: 0.41 [0.24-0.71]; compared with firehouse ambulance), visit at 18:00-07:59 (0.75 [0.64-0.88]), intentional injury (1.59 [1.03-2.47]; compared with non-injury), decreased level of consciousness (drowsy: 1.94 [1.33-2.84]; stupor: 4.08 [2.99-5.57]; coma: 1.81 [1.26-2.60]; compared with alert), severe illness diagnosis (1.49 [1.12-1.98]), the number of all beds in EDs (1.02 [1.01-1.04]), and acceptance for treatment (0.92 [0.87-0.98]; with increment of 1%). Conclusion This study confirms that both individual-level and hospital-level factors affect the transfer risk of severe pediatric patients in EDs. The study suggests the needs for direct transportation to specialized pediatric treatment facilities, and concentrated support for the pediatric emergency medical centers and pediatric trauma centers.

BACKGROUND AND PURPOSE: We aimed to investigate the usefulness of combining transcranial magnetic stimulation (TMS) and diffusion tensor tractography (DTT) to evaluate corticospinal tract (CST) integrity and subsequently predict ambulatory function after middle cerebral artery (MCA) stroke. METHODS: Forty-three patients with first MCA stroke underwent TMS and DTT to evaluate CST integrity. Patients were classified into four groups according to the presence of motor-evoked potentials (MEPs) obtained from the tibialis anterior muscle and CST integrity. Motor impairment and functional status were assessed using the Fugl-Meyer Assessment, Functional Ambulation Category, and Korean modified Barthel Index, both at the time of admission and after 4 weeks of rehabilitation. RESULTS: Patients with the presence of both measurable MEPs and a preserved CST showed better motor recovery and ambulatory function than other groups at the 4-week follow-up. Intact CSTs were not visualized in patients without detectable MEPs. Among the patients displaying MEPs, those with preserved CSTs showed better recovery of paretic lower extremities. CONCLUSIONS: Combined assessment using TMS and DTT to evaluate CST integrity confers advantages in predicting motor and ambulation recovery in patients with MCA stroke.
Diffusion* ; Follow-Up Studies ; Humans ; Locomotion ; Lower Extremity ; Middle Cerebral Artery ; Pyramidal Tracts ; Rehabilitation ; Stroke* ; Transcranial Magnetic Stimulation* ; Walking*

OBJECTIVE: To determine the supratentorial area associated with poststroke dysphagia, we assessed the diffusion tensor images (DTI) in subacute stroke patients with supratentorial lesions. METHODS: We included 31 patients with a first episode of infarction in the middle cerebral artery territory. Each subject underwent brain DTI as well as a videofluoroscopic swallowing study (VFSS) and patients divided were into the dysphagia and non-dysphagia groups. Clinical dysphagia scale (CDS) scores were compared between the two groups. The corticospinal tract volume (TV), fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated for 11 regions of interest in the supratentorial area—primary motor cortex, primary somatosensory cortex, supplementary motor cortex, anterior cingulate cortex, orbitofrontal cortex, parieto-occipital cortex, insular cortex, posterior limb of the internal capsule, thalamus, and basal ganglia (putamen and caudate nucleus). DTI parameters were compared between the two groups. RESULTS: Among the 31 subjects, 17 were diagnosed with dysphagia by VFSS. Mean TVs were similar across the two groups. Significant inter-group differences were observed in two DTI values: the FA value in the contra-lesional primary motor cortex and the ADC value in the bilateral posterior limbs of the internal capsule (all p<0.05). CONCLUSION: The FA value in the primary motor cortex on the contra-lesional side and the ADC value in the bilateral PLIC can be associated with dysphagia in middle cerebral artery stroke.
Anisotropy ; Basal Ganglia ; Brain ; Cerebral Cortex ; Deglutition ; Deglutition Disorders* ; Diffusion ; Extremities ; Gyrus Cinguli ; Humans ; Infarction ; Infarction, Middle Cerebral Artery* ; Internal Capsule ; Middle Cerebral Artery* ; Motor Cortex ; Prefrontal Cortex ; Pyramidal Tracts ; Somatosensory Cortex ; Stroke ; Thalamus

BACKGROUND: This study is intended to propose not only to introduce and evaluate the 2 years Clinical Research Coordinator (CRC) professional on-the-job training program that has been implemented in Samsung Medical Center on September of 2009, but also to develop the CRC future education program. METHODS: It is surveyed with self-report type for the 53 trainees, 18 non-trainees, and 17 investigators, the participants worked in Samsung Medical Center, and the major contents of the survey were general characteristics, training program evaluations, CRC qualification evaluation, and job satisfaction. The collected data was analyzed at the 0.05 level of significance by using SAS 9.1 version. RESULTS: The training program is conducted as 4 phases, each phase assessed separately. The Professional A course got the highest satisfaction, and it was deal with quality control (Mean=4.11 ~ 4.33). Most of the investigators answered that the trainees have high priority to be hired in the future (very much=82.45). The non-trainees answered that the training program would be helpful to improve the job competency and qualification (very much=22.2 %, somewhat=55.6 %) and 88.9 % of them answered that they have intention to participate in the training program. Finally, compared to non-trainees, the trainees have more job attachment (P=0.0036) and intention to continue CRC (P=0.0045). CONCLUSION: The CRC professional training program in Samsung Medical Center, as on the job training for 2 years, satisfies the investigators and trainees with positive effect on CRC job satisfaction and job stability. Based on this study, the education program with good quality should be developed considering the characteristics for each institution and close research field.
Humans ; Inservice Training ; Intention ; Job Satisfaction ; Korea ; Phenothiazines ; Quality Control ; Research Personnel

OBJECTIVE: To evaluate the reliability and validity of Korean version of AST (K-AST) as a bedside screening test of apraxia in patients with stroke for early and reliable detection. METHODS: AST was translated into Korean, and the translated version received authorization from the author of AST. The performances of K-AST in 26 patients (21 males, 5 females; mean age 65.42±17.31 years) with stroke (23 ischemic, 3 hemorrhagic) were videotaped. To test the reliability and validity of K-AST, the recorded performances were assessed by two physiatrists and two occupational therapists twice at a 1-week interval. The patient performances at admission in Korean version of Mini-Mental State Examination (K-MMSE), self-care and transfer categories of Functional Independence Measure (FIM), and motor praxis area of Loewenstein Occupational Therapy Cognitive Assessment, the second edition (LOTCA-II) were also evaluated. Scores of motor praxis area of LOTCA-II was used to assess the validity of K-AST. RESULTS: Inter-rater reliabilities were 0.983 (p<0.001) at the first assessment and 0.982 (p<0.001) at the second assessment. For intra-rater (test-retest) reliabilities, the values of four raters were 0.978 (p<0.001), 0.957 (p<0.001), 0.987 (p<0.001), and 0.977 (p<0.001). K-AST showed significant correlation (r=0.758, p<0.001) with motor praxis area of LOTCA-II test. K-AST also showed positive correlations with the total FIM score (r=0.694, p<0.001), the selfcare category of FIM (r=0.705, p<0.001) and the transfer category of FIM (r=653, p<0.001). CONCLUSION: K-AST is a reliable and valid test for bedside screening of apraxia.
Apraxias* ; Female ; Humans ; Male ; Mass Screening ; Occupational Therapy ; Reproducibility of Results* ; Self Care ; Stroke ; Upper Extremity