Chronic fibroinflammatory pancreatitis causes irreparable damage to the pancreatic parenchyma. This frequently results in food restrictions, painkiller addiction, and serious quality of life impairment in children. We observed a 13-year-old girl who had previously been hospitalized multiple times and had undergone acute pancreatitis arrived with excruciating abdominal pain and recurrent hematemesis. A chronic intra-pseudocyst bleed and an ampulla of Vater hemorrhage were discovered during an upper gastrointestinal endoscopy. A 3×2×1 cm pancreatic head pseudocyst was discovered on the magnetic resonance cholangiopancreatography, however the computed tomography scan revealed a pancreatic head pseudocyst, pancreatic duct stones, and substantial peripancreatic inflammation. The multidisciplinary team determined that Frey’s surgery was the most efficient method to minimize her suffering. No complications occurred during the healing phase following surgery, and two years later, neither recurrence bleeding nor abdominal pain appeared. In summary, Frey’s method is a secure and efficient intervention when applied by a multidisciplinary team.

Background: Research has been conducted on pain neuroscience education (PNE) for the relief of pain and symptoms associated with chronic neck pain (CNP). Focusing on the neurophysiology and neurobiology of chronic pain, pain processing, and particularly the function of the central nervous system for chronic pain, PNE helps patients to understand the causes of pain. Objectives: To investigate and systematically review interventional studies on the effectiveness of PNE for patients with CNP and to analyze the effect size by performing a meta-analysis. Design: A systematic review and meta-analysis protocol. Methods: The following databases and electronic collections will be searched for primary studies without time limits: PubMed, MEDLINE, OVID Embase, and CENTRAL in the Cochrane Library. Reference lists from identified studies will be manually hand-searched for additional relevant works. Patients 18 years of age and older with nonspecific neck pain lasting 3 months or longer will be included in the study, with exclusion criteria as follows: cancer pain, fractures of the spine or surgical intervention, cognitive impairment that does not allow the patient to follow the PNE program, pregnancy, chronic fatigue syndrome, fibromyalgia, and other related pathologies that may prevent full participation in the PNE program. There are no geographic restrictions; however, non- English studies will be excluded. Discussion: This study aims to evaluate the effects of PNE on pain and disability in chronic neck pain. Its results will help clarify whether the use of PNE alone can improve chronic pain. The advantages of systematic reviews include clear definitions and inclusion and exclusion criteria, standardized search formats, and objective independent reviews.

Background: Pain neuroscience education (PNE) with other therapeutic approaches can reduce pain intensity in patients with Chronic musculoskeletal pain and chronic spine pain by improving quality of life and disability. However, in various clinical trials and reviews, the optimal dose of an intervention combined with PNE is still an area to be studied. Objectives: To investigated the effect of forward head posture (FHP) with chronic neck pain on the PNE combined with cervical and thoracic mobilization. Design: A non-randomized, controlled intervention study. Methods: Thirty-two subjects were allocated to pain neuroscience education combined with cervical and thoracic mobilization group (PCTMG, n=17) and cervical and thoracic mobilization with TENS group (CTMG, n=15). For 6 weeks, the PCTM group applied PNE and cervical and thoracic mobilization and the CTM group applied cervical and thoracic mobilization and TENS. Changes in intervention pre-post pain and kinesiophobia were observed. Results: Results from the study indicated that statistically significant decrease in VAS and TSK-11 in PCTMG. In CTMG, there was a statistically significant decrease in VAS. And in PCTMG, there was a statistically significant decrease in VAS and TSK-11 than in CTMG. Conclusion: Therefore, this study confirmed that PNE combined with cervical thoracic mobilization is an effective intervention compared to ervical thoracic mobilization alone in reducing pain and kinesiophobia in FHP with chronic neck pain.

Background: Low back pain is a very common musculoskeletal disorder. Since low back pain can indicate physical and psychological problems, reducing the pain level of low back pain can be the primary goal of rehabilitation. Objectives: This study was performed to explain the personalized treatment protocol of Maitland orthopedic physiotherapy based on the brick wall concept for low back pain patients with hypomobility. Design: Randomized controlled study. Methods: A total of 14 chronic low back pain patients were divided into two groups. The experimental group received orthopedic manual physical therapy intervention. The control group received traditional physical therapy intervention. After the 3 days intervention, the joint range of motion and pain of the low back were measured. Results: The low back flexion, extension, lateral flexion, and rotation joint range of motion was significantly increased in the experimental group than in the control group (P<.05). Low back pain was significantly reduced in the experimental group than in the control group (P<.05). Conclusion: It was confirmed that Maitland orthopedic physical therapy was an effective method as an intervention method to improve the joint range of motion and pain of chronic low back pain patients.

Background: A recent study found that pain neuroscience education (PNE) alters pain intensity, knowledge of pain, disability, psychological function, and pain behavior in patients with musculoskeletal pain. However, they noted that PNE alone was not sufficient to affect chronic low back pain (CLBP) reduction. Objectives: To investigated the effect of CLBP on the PNE combined with lumbar mobilization. Design: Quasi-experiment study. Methods: A total of 33 patients aged 25 to less than 65, recruited from L-hospital for low back pain in Chungcheongnam-do. Out of 33 subjects, 17 were pain neuroscience education combined with lumbar mobilization group (PLMG) and 16 were lumbar mobilization group (LMG). The outcome was visual analogue scale (VAS), oswestry disability index (ODI) and the fear avoidance beliefs questionnaire (FABQ). The collected data was analyzed using the SPSS ver. 21.0 program by paired t-test and independent t-test. Results: PLMG was indicated statistically significant decrease in VAS, ODI and FABQ before and after intervention. However, there were statistically significant changes in VAS and ODI before and after intervention in LMG. PLMG and LMG before and after intervention indicated statistically significant differences in VAS, ODI and FABQ. Conclusion: The inclusion of PNE combined with lumbar mobilization in patients with CLBP is a promising and feasible approach to the management of CLBP.

Background: The purpose of this study was to investigate whether the function of stroke patients could be improved by simultaneously performing bridging and masticating exercises. And, this was tested by examining whether the effects of arousal and cognitive improvement due to mastication muscle activity could affect exercise ability. Objectives: To compare the effects, the movement of the center of pressure and the stability limit change were measured using a balance analysis platform (BT4). Design: Randomized controlled trial. Methods: In this study, 36 chronic stroke patients were randomly assigned to either single training group of the bridging exercise or combined training group that performed both the bridging exercise and the mastication exercise. The exercise was performed for thirty minutes a day, three times a week, for eight weeks. Results: In both groups, the static balance ability improved after exercise, but the dual-task training group had a better improving effect on the distance and area of the center of pressure while the eyes was open. The dynamic balance ability also improved after exercise, and the dual-task training was more effective in reducing forward, left, and right movements, but not in backward movement. Conclusion: The importance of mastication was recognized in the rehabilitation of chronic stroke patients, and it can be expected to use mastication to improve balance in stroke patients in the future.

목적: 국민건강영양조사 제7기(2016-2018) 원시자료를 이용하여 황반변성에 영향을 줄 수 있는 만성질환을 파악 하고자 수행되었다. 방법 : 국민건강영양조사 제7기(2016-2018) 자료 중 40세 이상의 성인 중에 황반변성 진단여부에 응답한 4,356명의 대상으로 만성질환과의 관계를 분석하였으며, p<0.05인 경우 유의한 것으로 판단하였다. 결과 : 황반변성은 연령에 따라 유병률이 높아졌는데, 연령과 관계된 만성질환 중 심근경색증에서만 유의한 결 과를 얻을 수 있었다. 또한, 심근경색증의 위험요인인 이상지질혈증과 이상지질혈증을 일으키는 고콜레스테롤혈증 도 황반변성과 관계가 있는 것으로 나타났다. 결론 : 황반변성은 연령과 관련된 만성질환 중 심근경색증, 이상지질혈증, 고콜레스테롤혈증과 관련이 있음을 확인하였다.

Pancreatic cancer can arise in the background of chronic pancreatitis (CP). The relative risks for pancreatic cancer in CP vary considerably according to other contributing factors such as disease duration, excess alcohol consumption, tobacco consumption, eating habits, physical activity, and late-onset diabetes. The incidence of pancreatic cancer is estimated to be about 10 per 105 per year, and the incidence and prevalence of CP are estimated to be 5-12 per 105 and 50 per 105 per year, respectively. The pooled relative risk estimates for pancreatic cancer in CP patients range from 2.7 to 13.3. Subsets of CP subjects with a family history of pancreatic cancer or those with newly developed diabetes over the age of 50 have a higher risk for pancreatic cancer. However, the prevalence of pancreatic cancer is not high enough to justify general screening of the adult CP population. Thus, it is necessary to select subsets of CP cohorts with a significantly high risk of pancreatic cancer. We need a better overall disease model that can define the interaction of multiple risk factors and their cumulative or potential effects on pancreatic cancer.

The aging society are causing complicated problems from chronic diseases such as diabetes, heart disease in aged patients. Recently Covid pandemic swept across global aging societies and put aged people with chronic disease more vulnerable to mobidity. Therefore, from view of preventive and precision medicine, remote monitoring an aged people with chronic disease is an important issue than ever. Smart health care systems as remote monitoring is so called telemetry system which enable doctors or health care providers to manage remotely to consult, diagnose and treat patients with chronic disease and infectious disease as well. The goal of telemetry system is to meet timely medical need in aged patients in distant place through communication technologies. Through technological breakthrough, particularly in real-time health care industry, Telemetry system with realtime mornitoring of heart rhythm and blood glucose level can play an important role in managing healthcare services in aged patients. This report introduces a comprehensive and inclusive review on the usefulness of realtime patiens monitoring with wearable sensors in telemedicine applications. The findings of this report are as follows: (1) The advantage of real-time monitoring and blood glucose level and biofeedback based on visual data (2) The advantage of realtime-monitoring heart rhythm coupled with blood glucose level. (3) There is an additional need to produce a digital imaging from protable diagnostic divices such as X-ray and ultrasound.

Background: Bird dog exercise (BDE) is one of the lumbar stabilization exercises that rehabilitate low back pain by co-contraction of the local and global muscles. Previous studies have reported the effect of various type of BDEs (for example, practicing the exercises on various surfaces and changing the limb movement) for muscle co-contraction. Objects: This study aimed to investigate the effect of knee joint flexion position of the raised lower limb on abdominal and back muscle activity during BDE in patients with chronic low back pain (CLBP). Methods: Thirteen males participated in this study (age: 32.54 ± 4.48 years, height: 177.38 ± 7.17 cm). Surface electromyographic (SEMG) data of the internal abdominal oblique (IO), external abdominal oblique (EO), lumbar multifidus (MF), and thoracic part of the iliocostalis lumborum (ICLT) were collected in two knee joint flexion positions (90° flexion versus 0° flexion) during BDE. The SEMG data were expressed as a percentage of root mean square mean values obtained in the maximal voluntary isometric contraction. Results: Greater muscle activity of the IO (p = 0.001), MF (p = 0.009), and ICLT (p = 0.021) of the raised lower limb side and the EO (p = 0.001) and MF (p = 0.009) of the contralateral side were demonstrated in the knee joint flexion position compared to the knee joint extension position. Greater local/global activity ratios of the abdominal muscle (i.e., IO and EO) of the raised lower limb (p = 0.002) and the back muscle (i.e., MF and ICLT) of the contralateral side (p = 0.028) were also noted in the knee joint flexion position. Conclusion: BDE with a knee joint flexion position might be recommended as an alternative lumbar stabilization exercise to enhance muscle activity in both the raised lower limb and the contralateral sides of the trunk for individuals with CLBP

Background: Neck pain is a major health problem in developed countries and has a lifetime prevalence of 50%. Major problems include a reduced cervical range of motion, muscle stiffness, dysfunction, postural changes, and decrease in psychosocial level. Objects: This study aimed to investigate the effects of applying the upper trapezius inhibition dynamic taping to patients with chronic neck pain on their neck pain, functional level, cervical range of motion, psychosocial level, and neck posture. Methods: The study design was a randomized controlled trial. A total of 40 patients with neck pain participated in this study and were randomly assigned to a Dynamic Taping group (n = 20) or Sham Taping group (n = 20). In both groups, basic intervention cervical pain control therapy and shoulder stabilization exercise program were performed. In addition, dynamic taping and sham taping were applied to participants in the Dynamic Taping and Sham Taping groups to inhibit the trapezius muscle, respectively. All interventions were performed three times a week and a total of 12 times for 4 weeks, and the participants’ neck pain, functional impairment level, cervical range of motion, psychosocial level, and neck posture were measured and compared before and after the intervention. Results: Both groups showed significant differences in neck pain, functional level, cervical range of motion, psychosocial level, and neck postural before and after the intervention (p < 0.05). Moreover, there were significant differences between the two groups regarding the functional level and neck posture (p < 0.05). Conclusion: Inhibition dynamic taping of the upper trapezius muscle suppression is an effective method with clinical significance in reducing pain in individuals with chronic neck pain and improving the functional level, cervical range of motion, psychosocial level, and neck posture.

Background: Since chronic ankle instability (CAI) can adversely affect postural control, core stability exercises have been investigated to improve postural control. However, only a few studies have focused on kinetic chain exercises. Objectives: To investigate the effects of open kinetic chain (OKC) and closed kinetic chain (CKC) core stability exercises on static and dynamic balance abilities and vertical jump height in CAI patients. Design: Randomized controlled trial. Methods: The 18 participants enrolled in this study were randomly divided into the OKC group (n=9) and CKC group (n=9). Static and dynamic balance abilities and vertical jump height were measured before and after the intervention. The intervention program comprising OKC or CKC core stability exercises depending on the groups was conducted for 30 min twice a week for 6 weeks in 12 sessions. Results: In the OKC group, static measured with the eyes open or closed and dynamic balance abilities were significantly improved after the intervention (P<.05). In the CKC group, dynamic balance ability was significantly increased (P<.05). A significant difference was observed in static balance ability measured with the eyes open between the two groups (P<.05). Vertical jump height was significantly increased after the intervention in both groups (P<.05). Conclusion: OKC and CKC core stability exercises improve static and dynamic balance abilities and vertical jump height in CAI patients. Specifically, the OKC core stability exercise was more effective in enhancing static balance ability than the CKC core stability exercise.

A cat who is a 15-year-old and spayed female visited an animal clinic with severe coughing symptoms. Since the cat’s coughing symptoms had worsened from the age of 10 and X-rays showed a bronchial pattern in the lungs, it was diagnosed as Chronic Obstructive Pulmonary Disease (COPD). She received three injections of stem cells isolated from the amniotic membrane on days 0, 7, and 23. Although there was no improvement in the clinical findings on the x-ray, the number of coughing was significantly reduced. In addition, even after long-term follow-up post treatment for a month, she was stable with almost no coughing.

Treatment and management of chronic low back pain (CLBP) should be tailored to the patient’s individual context. However, there are limited resources available in which to find and manage the causes and mechanisms for each patient. In this study, we designed and developed a personalized context awareness system that uses machine learning techniques to understand the relationship between a patient’s lower back pain and the surrounding environment. A pilot study was conducted to verify the context awareness model. The performance of the lower back pain prediction model was successful enough to be practically usable. It was possible to use the information from the model to understand how the variables influence the occurrence of lower back pain.

Background: Postural control deficit is a major characteristic in patients with chronic ankle instability (CAI). Elastic ankle tapings are commonly used to facilitate postural control in patients with CAI as well as prevent relapse of a lateral ankle sprain. However, equivocal evidence exists concerning the effect of elastic ankle taping on postural control. Objects: This study aimed to evaluate the effects of elastic ankle tapings using kinesio taping (KT) and dynamic taping (DT) on static and dynamic postural control in patients with CAI. Methods: Fifteen subjects with CAI were participated in this study. The participants performed tests under three conditions (barefoot, KT, and DT). Static postural control was evaluated using the one-leg standing test (OLST) and dynamic postural control using the modified Star Excursion Balance Test (mSEBT). One-way repeated-measures analysis of variance was used to compare center of pressure (CoP) data and normalized mSEBT reach distances among the three conditions (with α = 0.05). Results: The CoP parameters (path length, ellipse area, and mean velocity) of the OLST significantly decreased on applying KT and DT compared with those when barefoot. The normalized reach distances in the anteromedial (AM), medial (M), and posteromedial (PM) directions of the mSEBT significantly increased with DT compared to that in the control condition. Further, the higher reach distances with KT compared with those in the control condition were obtained in the M and PM directions of the mSEBT. No significant differences were identified in any of the OLST and SEBT parameters between the two different taping applications. Conclusion: KT and DT improved static postural control during the OLST compared with the control condition. Moreover, these tapes improved dynamic postural control during the mSEBT compared to the control. Therefore, elastic ankle tapings are useful prophylactic devices for the prevention and treatment of ankle sprain in people with CAI.

Background: Back pain is associated with a high risk of recurrence. Various physical therapy techniques for back pain have been studied, including reprogramming the central nervous system by integrating sensation and motion with sensory exercise training. Objectives: To aimed verify the effectiveness of sensorimotor training in improving postural stability and pain levels. Design: A randomized controlled trial. Methods: The study population was randomized into a sensory exercise training group and trunk stabilization training group and treated three times a week for 4 weeks. Each group took part in sensorimotor training for 15 minutes or lumbar stabilization exercise for 15 minutes. Results: After the intervention both groups showed Improvements in the variables. There was a significant difference in the dynamic postural stability, limit of stability, and modified visual analog scale scores in the sensorimotor training group compared to the lumbar stabilization exercise group (P<.05). Conclusion: Sensorimotor training appears to be an effective physical therapy exercise program that can be applied in patients with low back pain to improve muscle control ability.

Three different cats who had chronic kidney disease (CKD) were treated for more than one month with fluid therapy in an animal clinic. Although this long-term treatment and hospitalization, there was no clinical improvement in clinical signs as well as serum biochemical indexes including blood urea nitrogen (BUN), creatinine (CREA), and phosphate (PHOS). All cases were then injected three times with allogeneic stem cells through an intravenous route for treatment on Day 0, 7, and 14 or 30. On the same day, clinical observation and blood tests for serum biochemistry were conducted together. Upon administrating stem cells to the CKD cats, clinical conditions and the indexes of BUN and CREA were clinically improved within normal ranges. Additionally, one of the cats who had the renal cysts presented clinical improvement with showing decreased cysts size than before.

목적 : 본 연구의 목적은 최근 10년간 뇌졸중 환자의 상지기능 회복을 위해 사용된 가상현실 중재들에 대해 알아보고 체계적으로 고찰을 실시하고자 한다. 연구방법 : 2010년 1월부터 2020년 12월까지 Research Information Sharing Service(RISS), Koreanstudies Informatin Service System(KISS), DBpia, PubMed, ScienceDirect, Scopus의 온라 인 데이터 베이스에 등록된 논문을 검색하였다. 최종적으로 18개의 Randomized Controlled Trials(RCT) 논문을 대상으로 PICO 방법을 사용하여 분석하였다. 결과 : 뇌졸중 환자의 상지기능 회복을 위해 사용된 가상현실 중재방법은 9개였고, 총 18회 사용되었다. 그중 Nintendo Wii가 4회(22.22%), 가상현실 프로그램이 4회(22.22%)로 가장 많았다. 연구 분석 결과 뇌졸중 환자의 상지기능 향상에 Nintendo Wii와 가상현실 프로그램이 효과적인 것으로 나타났다. 결론 : 뇌졸중 환자의 상지기능 향상을 위한 가상현실 중재방법의 종류와 빈도를 제시하였고 가장 많이 사용되는 Nintendo Wii와 가상현실 프로그램의 중재 방법에 대한 근거 논문들을 중재 방법, 중재 기간 및 횟수, 중재효과를 표로 만들어 제시하였다. 결과는 임상 치료사들이 치료방법 및 기간, 평가도구를 선택하는데 근거 자료로 사용할 수 있을 것이다.