[Background] Over the last thirty years, majority of researches on clinical effectiveness of acupuncture have been explanatory (or experimental) randomized controlled trial. The benefits of acupuncture in clinical trials are stillcontroversial and most studies concluded that further control studies were required. Standardized combinations of acupuncture points for all the experimental subjects in various past studies have been criticized because such treatments do not reflect current routine clinical treatment.
[Objective] This paper aims to review pragmatic clinical trials on the effect of acupuncture treatment and to develop the ideal clinical research methodology of acupuncture study.
[Method] Clinical studies of acupuncture relevant with pragmatic or individualized trials were searched mainly in Pubmed and Science direct databases. All articles were fully reviewed by researchers, and data were evaluated by usage of a standardized form.
[Results & Suggestion] Pragmatic acupuncture researches were tried for various symptoms (eg. low back pain, hypertension, depression during pregnancy, sleep quality in HIV disease, chronic poststroke leg spasticity, headache, etc). Individualized acupuncture treatments based on oriental disease pattern diagnosis reflexes practical treatments which is more effective than unified and fixed acupuncture treatments without any theoretical basis of oriental medical philosophy.
[Conclusion] To overcome the controversies and limitations of past explanatory acupuncture trials, more individualized and tailored acupuncture trials with the theoretical basis of oriental medical diagnosis is highly recommended. Also clear definition and categorization of pattern identification should be established for further active clinical researches and applications of acupuncture.

No abstract available in English.
Clinical Study ; Dislocations ; Hip

Four patients with advanced tuberculosis of the wrist joint were treated with curettage & radial sliding graft to obtain radiometacarpal fusion. After each follow-up, their results were complete relief of pain with eradication of focus and solid union. This graft affords the stability of cortical bone combined with the osteogenesis of cancellous or trabecular bone. It furthermore affords a shape that conforms to the desirable dorsiflexion of the wrist after fusion.
Arthrodesis ; Curettage ; Follow-Up Studies ; Humans ; Osteogenesis ; Transplants ; Tuberculosis ; Wrist Joint ; Wrist

No abstract available.
Blood Donors* ; Chungcheongnam-do* ; Humans

STUDY DESIGN: A case report. OBJECTIVES: Lumbar burst fracture was treated with operation, which delayed recollapse of L1 and led to conus medullaris syndrome. SUMMARY OF LITERATURE REVIEW: After operation, conus medullaris syndrome causing by delayed recollapse is not frequently reported. MATERIALS AND METHODS: A 56-year-old male was admitted with lower back pain caused by a fall. Radiologic findings showed L1 burst fracture with about 42% of height loss. There was no neurologic deficit. Posterior fusion was performed using instrumentation. Five weeks after the operation, the patient was admitted for urination and defecation difficulty. Radiologic findings showed that the L1 had recollapsed with about 38% of height loss. To resolve the problem, anterior surgery was performed. RESULTS: Two years after surgery, bladder and anal sphincter dysfunction wasn't recovered. CONCLUSIONS: Lumbar burst fracture should be follow up carefully until union of the fracture because burst fracture leads to delayed recollapse.
Anal Canal ; Defecation ; Humans ; Low Back Pain ; Male ; Middle Aged ; Neurologic Manifestations ; Spinal Cord Compression* ; Urinary Bladder ; Urination

OBJECTIVES: The presence of psychiatric disorders including depression and anxiety disorders is considered to be the most important risk factor of suicide. Also, suicidal risk is known to be increased in patients who have serious medical illnesses. Like in patients with other medical illness, some authors reported that suicidal risk is increased in patients with stroke. But there have been no reports with Korean patients. The aim of this study is to investigate the frequency of suicidal ideation of patients in the acute stage of stroke, and to examine the demographic characteristics, and psychiatric and neurological symptoms between the patients with and without suicidal ideation. METHODS: Seventy seven hospitalized stroke patients at the Hallym Stroke Center from July of 1999 to June of 2000 were included in this study. Beck Suicidal Ideation Scale(BSIS) was used to evaluate suicidal ideation. Beck Depression Inventory(BDI) and Beck Anxiety Inventory(BAI) for depression and anxiety, and Social Support Scale(SSS) for social support system of the stroke patients were used. Neurologic disabilities were rated with National Institutes of Health Stroke Scale(NIHSS) and Barthel's Index. RESULTS: Thirty five percent(N=27) of the stroke patients reported severe suicidal ideation. Scores of BDI, BAI and SSS were higher in the patients with severe suicidal ideation than their counterpart. There were no differences in Barthel's index score and NIHSS between two groups. Most patients with severe suicidal ideation had depressive or anxiety symptoms. But patients without depressive or anxiety symptoms also reported severe suicidal ideation. CONCLUSIONS: Thirty five percent of stroke patients in acute stage of their illness have severe suicidal ideation that requires careful psychiatric evaluation and intervention. Inclusion of routine assessment of suicidal ideation in these patients is recommended.
Anxiety ; Anxiety Disorders ; Depression ; Humans ; National Institutes of Health (U.S.) ; Risk Factors ; Stroke* ; Suicidal Ideation* ; Suicide

The size of spinal canal is mesured to detect the lumbar spinal stenosis syndrome and expanding intraspinaltumors by CT. This study was desinged for taking accurate measurement of the normal lumbar spinal canal in Koreanadults. The anteroposterior diameter, interpediculate distance and cross-sectional area of lumbar spinal canalwere measured in 110 normal adults. The results were as follows; 1. The window center that showed identical valueconsistent with actual measurement of phantom was between + 160HU and + 240HU and the window width was below +300HU. 2. In anteroposterio diameter, upper part of the canal was larger value than that of middle and lowerparts, but in interpediculate distance, lower part of the canal revealed larger value than that of upper andmiddle parts. There was no significant difference in cross-sectional area. 3. All measurements male were largerthan those of female at all levels of the spinal canal and 42 measurements(58%) were significant statisstically.4. Compared with Americans, Korean showed lower value in anteriopsterior diameter and cross-sectional area buthigher value in interpediculate distance. 5. Above results should contribute to making an another criteria fordiagnosing the lumbar spinal stenosis in Koreans.
Adult ; Asian Americans ; Female ; Humans ; Male ; Spinal Canal ; Spinal Stenosis

Anticancer effect and complications were evaluated after transcatheter arterial embolization(TAE) in 12patients with hepatocellular carcinoma until 2 weeks and 4 weeks after TAE, respectively. The results were asfollows: 1. Serum alpha-fetoprotein value decreased in 7 out of 9 patients wih high value prior to TAE. 2. Loss ofenhancement and better definition on enhanced CT were seen in the tumors in all cases, and low-density areas in9/10 . Gas bubbles were seen in low-density areas in 4/10 and highdensity area caused by lipiodol in 6/10. 3.Post-embolization syndrome was develped in most patients but improved clinically within a week after TAE. 4. Onlaboratory examination, impairment of liver function was developed in most patients but improved within 4 weeksafter TAE. 5. Complications on CT included splenic infarction and thickening of wall of the gallbladder, whichdidn't require specific treatment. The authors conclude that TAE for hepatocellular carcinoma reveals apparentanticancer effect on shortterm evaluation, and resultant complications are transient and improved by conservativetreatment.
alpha-Fetoproteins ; Carcinoma, Hepatocellular ; Ethiodized Oil ; Gallbladder ; Humans ; Liver ; Splenic Infarction

No abstract available.
Adult* ; Humans ; Neck*

Background: Although guidelines recommend vaccination for individuals who have recovered from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to prevent reinfection, comprehensive evaluation studies are limited. We aimed to evaluate vaccine effectiveness against SARS-CoV-2 reinfection according to the primary vaccination status, booster vaccination status, and vaccination methods used. Methods: This population-based case-control study enrolled all SARS-CoV-2-infected patients in Seoul between January 2020 and February 2022. Individuals were categorized into case (reinfection) and control (no reinfection) groups. Data were analyzed using conditional logistic regression after adjusting for underlying comorbidities using multiple regression. Results: The case group included 7,678 participants (average age: 32.26 years). In all vaccinated individuals, patients who received the first and second booster doses showed reduced reinfection rates compared with individuals who received basic vaccination (odds ratio [OR] = 0.605, P < 0.001 and OR = 0.002, P < 0.001). Patients who received BNT162b2 or mRNA-1273, NVX-CoV2373 and heterologous vaccination showed reduced reinfection rates compared with unvaccinated individuals (OR = 0.546, P < 0.001; OR = 0.356, P < 0.001; and OR = 0.472, P < 0.001). However, the ChAdOx1-S or Ad26.COV2.S vaccination group showed a higher reinfection rate than the BNT162b2 or mRNA-1273 vaccination group (OR = 4.419, P < 0.001). Conclusion In SARS-CoV-2-infected individuals, completion of the basic vaccination series showed significant protection against reinfection compared with no vaccination. If the first or second booster vaccination was received, the protective effect against reinfection was higher than that of basic vaccination; when vaccinated with BNT162b2 or mRNA-1273 only or heterologous vaccination, the protective effect was higher than that of ChAdOx1-S or Ad26.COV2.S vaccination only.