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The prevalence of musculoskeletal disorders in South Korea has surged due to the rapid aging of the population, emerging as a significant driver of increased healthcare costs. In particular, manual therapy is a representative non-insured treatment for musculoskeletal disorders, and according to media reports, the expenses paid by insurance companies for manual therapy exceeded 1 trillion won in 2021, making it the largest single non-insured treatment item. The National Health Insurance Service’s 2021 report on health insurance coverage identified manual therapy as a major factor contributing to declining health insurance coverage rates. Despite being recognized as an effective treatment for musculoskeletal disorders, manual therapy lacks clear criteria regarding the indications and application frequencies, and it is being performed without clear standards for specialized medical departments. Some have even raised ethical issues for medical institutions and professionals, highlighting social problems. Before December 2005, manual therapy was restricted to specialized fields, such as orthopedics, rehabilitation medicine, and neurosurgery. On the other hand, the transition of manual therapy to non-insured status in December 2005 has allowed its prescription by non-specialized medical departments for musculoskeletal disorders, leading to widespread practices even in unrelated medical specialties and contributing to over-treatment. Given these situations, establishing objective criteria for manual therapy is vital. This study aimed to establish a foundation for solving social problems by grasping the latest perspectives on manual therapy based on an extensive literature review and a survey of experts. [ABSTRACT FROM AUTHOR]

Purpose: The efficacy and safety of low-dose pregabalin and alpha lipoic acid in diabetic neuropathy were evaluated and analyzed. Materials and Methods: This study designed a retrospective study that included patients with diabetic neuropathic pain. From 2009 to 2022, 100 patients who suffered from diabetic neuropathic pain were included in this study. The patients were divided into group I (pregabalin 150 mg/day with alpha lipoic acid 600 mg/day) and group II (pregabalin 300 mg/day with alpha lipoic acid 600 mg/day). The visual analogue scale (VAS), medication side effects, and neurometer results were compared. Results: The mean follow-up period of the above patients was 120.23 weeks in group I and 149.05 weeks in group II. The average VAS score in group I decreased by 3.23 points, and the average VAS score in group II decreased by 2.86 points. Approximately 24.3% of group I had side effects, such as dizziness, sleepiness, and gastrointestinal trouble, while 76.7% of patients in group II had side effects. Sixty- seven patients had a neurometer examination before and after the medication, and there is no statistical difference between the two groups. Conclusion: The combination of low-dose pregabalin (pregabalin 150 mg/day) and alpha lipoic acid in diabetic neuropathy had a similar clinical effect and less frequent medication side effects than regular dose pregabalin (pregabalin 300 mg/day) and alpha lipoic acid. Therefore, low-dose pregabalin (pregabalin 150 mg/day) and alpha lipoic acid should be considered in treating diabetic neuropathy. [ABSTRACT FROM AUTHOR]

With the development of computer vision systems, many advances have been made in the fields of surveillance, biometrics, medical imaging, and autonomous driving. In the field of autonomous driving, in particular, the object detection technique using deep learning are widely used, and the paved road detection is a particularly crucial problem. Unlike the ROI detection algorithm used in general object detection, the structure of paved road in the image is heterogeneous, so the ROI-based object recognition architecture is not available. In this paper, we propose a deep neural network architecture for atypical paved road detection using Semantic segmentation network. In addition, we introduce the multi-scale semantic segmentation network, which is a network architecture specialized to the paved road detection. We demonstrate that the performance is significantly improved by the proposed method. [ABSTRACT FROM AUTHOR]

The task of defining the concept of ‘disability’ has proven to be surprisingly difficult. The way disability is assessed in the world suggests that very different conceptions of disability are being presumed. It is very hard to suggest appropriate criteria for assessing a disability that accurately demonstrates the presence and measures the severity of the disability, with proven consistency and validity provided by the assessors consuming the time and cost that the society can afford. When a rigorous framework in disability assessment procedures is used, discretion is then considerably restricted. Limited discretion tends to produce more consistency and validity in the assessment but at the cost of ignoring the individual differences or exceptional circumstances. The disability approach among the categories of the disability assessment is both the oldest and the most commonly used strategy of disability assessment around the world. Most of the criteria of disability assessment in Korea belongs to this. The McBride’s criteria for disability evaluations can be used to obtain the ratio of body impairment and work disability without spending too much time and is being applied in court. Nevertheless, there are many errors and controversies, and corrections are required. On the other hand, an improvement plan for a disability evaluation method in Korea is to supplement and use the McBride’s disability assessment method, which is currently the most widely used. This review article describes the conception of disability and the assessment of disability, and introduces the models of the assessment of disability to determine if the application of the McBride’s criteria of disability evaluation can be justified. [ABSTRACT FROM AUTHOR]

Text region detection is a technology that detects text area in handwriting or printed documents. The detected text areas are digitized through a recognition step, which is used in various fields depending on the purpose of use. However, the detection result of the small text unit is not suitable for the industrial field. In addition, the border of tables in the document that it causes miss-detected results, which has an adverse effect on the recognition step. To solve the issues, we propose a method for detecting text region using the border information of the table. In order to utilize the border information of the table, the proposed method adjusts the flow of two decoders. Experimentally, we show improved performance using the table border pseudo label based on weak supervised learning. [ABSTRACT FROM AUTHOR]

Neurofibromatosis type 1 (NF1) is a common autosomal-dominant disorder. Vasculopathies associated with NF1 are rare and can cause aneurysms, stenoses, and arteriovenous malformations. Aneurysms may rupture spontaneously, which could be fatal. Spontaneous mesenteric hemorrhage due to rupture of an inferior mesenteric artery aneurysm associated with NF1 has rarely been reported. Herein, we report a case of spontaneous rupture of a fusiform aneurysm in the superior rectal artery in a 56-year-old woman with NF1 who was successfully treated with transcatheter arterial embolization. [ABSTRACT FROM AUTHOR]

The progression of aging and the increase in musculoskeletal diseases have led to an increase in invasive treatment methods, including various surgical methods, but conservative treatment should be attempted before surgical treatment in musculoskeletal diseases. Medication for pain control, such as acetaminophen, non-steroidal anti-inflammatory drugs, steroid, opioids, antidepressants, etc., is one of the most popular methods for pain control. If the pain receptors on peripheral organ are stimulated, pain is transmitted to the brain by the ascending pathway, and the brain then secretes endogenous opioids, such as endorphin, by the descending pathway for pain control. Opioids are substances that act on the opioid receptors, and there are three receptors for opioids. The affinity for each receptor varies according to the tissue and the patient's systemic status. Antidepressants work on the synapses in the central nervous system and its main mechanism is regulation of the ascending pathway. This is mainly effective in chronic pain and neuropathic pain, which is similar in effectiveness to opioids. This review focuses on the effectiveness, method of use, and side effects of opioids and antidepressants. [ABSTRACT FROM AUTHOR]

Duodenal varices can develop in patients with portal hypertension secondary to liver cirrhosis. Although upper gastrointestinal bleeding is often severe and fatal, the definite treatment or guideline has not been established. Although endoscopy is the primary therapeutic modality, the use of radiologic interventions, such as transjugular intrahepatic portosystemic shunt, balloon or vascular plug-assisted retrograde transvenous obliteration, and percutaneous transhepatic variceal obliteration, can be considered alternative treatment methods for duodenal varices. Herein, we report a case of duodenal varix in a patient with poor hepatic functional reserve and vascular anatomy, which are contraindications for an occlusion balloon or a vascular plug, successfully treated with coil-assisted retrograde transvenous obliteration. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficiency of the electronic foot function index (eFFI) through a prospective, random based, multi-institutional study. Materials and Methods: The study included 227 patients ranging in age from 20 to 79 years, visited for surgery in different 15 institutes, and agreed to volunteer. The patients were assigned randomly into a paper-based evaluated group (n=113) and tablet-based evaluated group (n=114). The evaluation was done on the day of hospital admission and the method was changed on the second day of surgery and re-evaluated. PADAS 2.0 (https://www.proscore.kr) was used as an electronic evaluation program. Results: There were no differences in age and sex in both groups. The intraclass correlation coefficient (ICC) evaluation revealed an eFFI ICC of 0.924, showing that both results were similar. The evaluation time was shorter in the tablet-based group than the paperbased group (paper vs tablet, 3.7±3.8 vs 2.3±1.3 minutes). Thirty-nine patients (17.2%) preferred to use paper and 131 patients (57.7%) preferred the tablet. Fifty-seven patients (25.1%) found both ways to be acceptable. Conclusion: eFFI through tablet devices appears to be more constant than the paper-based program. In addition, it required a shorter amount of time and the patients tended to prefer the tablet-based program. Overall, tablet and cloud system can be beneficial to a clinical study. [ABSTRACT FROM AUTHOR]

Purpose: Treatment of diabetic foot infection due to methicillin-resistant Staphylococcus aureus (MRSA) remains challenging. Applying vancomycin-impregnated cement is one of the best methods of treatment. Vancomycin-impregnated cement has been used worldwide; however, to date, there is a limited number of studies regarding its use. We evaluated the duration of antimicrobial activity of vancomycin-impregnated cement stored at room temperature after manufacturing. Materials and Methods: The vancomycin-impregnated cement was manufactured by mixing 1 g of vancomycin with 40 g of polymer and adding 17.90 g of liquid monomer. The cement dough was shaped into flat cylinders with diameter and height of 6 mm and 2 mm, respectively. Another cement of the same shape without mixing vancomycin was prepared as the negative control. All manufactured cements were sterilized with ethylene oxide gas and stored at room temperature. Each cement was placed on Mueller Hinton agar plate lawned with standard MRSA strain. Standard vancomycin disk and gentamicin disk were placed together. After 24 hours, the diameter of inhibition zone was measured, and if the diameter was less than 15 mm, vancomycin-impregnated cement was regarded as a loss of antimicrobial activity. The study was repeated every 2 weeks until vancomycin-impregnated cements lost their antimicrobial activity. Results: Vancomycin-impregnated cement stored for a duration of 16 weeks created a 14 mm inhibition zone, while vancomycin disk created a 15 mm inhibition zone. Vancomycin-impregnated cement stored for a duration of 17 weeks created 7 mm and 9 mm inhibition zones, while vancomycin disk created 16 mm and 15 mm inhibition zones, respectively. Conclusion: We found a decrease of antimicrobial activity in vancomycin-impregnated cements after 16 weeks. After 17 weeks, they showed definite loss of antimicrobial activity. Therefore, we recommend not using vancomycin-impregnated cement spacers that has been stored for more than 16 weeks at room temperature. [ABSTRACT FROM AUTHOR]