Songdo Hospital

Background and Objectives: Musculoskeletal pain is a global public health issue. Eight Constitution Medicine (ECM), a type of East Asian Traditional Medicine, offers personalized, minimally invasive treatment through Eight Constitution Acupuncture (ECA) and Eight Constitution Lifestyle Intervention (ECLI). Despite its clinical use, scientific evidence supporting ECM’s effectiveness remains limited. This study aimed to evaluate the effectiveness in treating musculoskeletal pain in primary care settings. Materials and Methods: This retrospective study analyzed medical records from three ECM clinics (Gangnam-Shingwang, Yeson, and Yebon) between January 2018 and August 2023. A total of 163 patients were included, with 44 providing follow-up data. Pain intensity, quality of life, and functional outcomes were assessed using validated instruments including the PainDETECT questionnaire, Korean Cancer Pain Assessment Tool (KCPAT) somatic pain scores, EuroQol 5-Dimension 5-Level (EQ-5D-5L), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oswestry Disability Index (ODI), Neck Disability Index (NDI), and Shoulder Pain and Disability Index (SPADI). Pre- and post-treatment scores were statistically analyzed. Results: Significant decreases were observed in KCPAT somatic pain scores (11.77 ± 4.77 to 9.77 ± 5.32) and significant improvements in EQ-5D-5L scores (0.74 ± 0.12 to 0.80 ± 0.07). WOMAC and ODI scores also showed significant improvements. However, the changes in the NDI, SPADI, and PainDETECT scores were not statistically significant. No adverse events were reported. Conclusions: ECM, through ECA and ECLI, may offer effective personalized treatment for musculoskeletal pain, improving both pain intensity and quality of life. Despite its small sample size and retrospective design, this study offers valuable preliminary evidence for ECM. Further large-scale prospective studies are needed to confirm these findings.

In this study, we propose a multimodal deep learning model to predict the thickness and elasticity of blood clots (thrombi) using ultrasound imaging. We utilized an open dataset, Mus-V: Multimodal Ultrasound Vascular Segmentation, to train and evaluate our model. The model processes three types of ultrasound data: 1D ultrasound signals, 2D frequency-domain images obtained through Fast Fourier Transform (FFT), and Doppler ultrasound data. Each data type is analyzed using separate convolutional neural networks (CNNs) to extract important features. These features are then combined in fully connected layers to predict the thickness and elasticity of the thrombus. Our results demonstrate that combining multiple data modalities significantly improves prediction accuracy compared to models using a single data type. This approach highlights the potential for improving the early diagnosis and treatment of blood clot-related diseases through advanced multimodal deep learning techniques.

Background: This study is a comparative analysis of legal decisions by the Korean judiciary regarding human health effects of radiation exposure in lawsuits related to the linear no threshold hypothesis of the International Commission on Radiological Protection (ICRP), particularly following the Fukushima nuclear power plant accident in 2011.Materials and Methods: The legal cases related to radiation exposure and human health effects were searched and compiled using legal databases such as ‘national law information center,’ ‘case note,’ and ‘LBOX.’ Keywords such as ‘radiation,’ ‘human health effects,’ ‘lawsuit,’ ‘radiation effects,’ and ‘disease’ were used to search for relevant legal cases, leading to the identification of a total of nine legal decisions. The original texts of these cases were analyzed. The analysis categorized the cases based on the distinction between the plaintiff, radiation doses, types of diseases, and the results of the lawsuits.Results and Discussion: Four lawsuits ruled that there is a causal relationship between radiation exposure and human health effects. These rulings were made in 2016 (two cases), 2018, and 2022. In cases where the radiation exposure doses were precisely recorded as 1.71 mSv and 2.09 mSv, the rulings also concluded that there was a causal relationship between radiation exposure and human health effects. In contrast, five lawsuits concluded that there was no causal relationship between low-dose radiation exposure and human health effects, ruling that a radiation exposure of 12.25 mSv was not related to the disease.Conclusion: Judicial rulings on radiation risks must be consistent and equitable. The ICRP recommends standards for radiation protection and dose limits. Based on these recommendations, the executive branch must establish consistent guidelines, and judicial rulings must maintain consistency in accordance with these standards.

Melasma, a common skin hyperpigmentation disorder, has traditionally been linked to hormonal changes in genetically predisposed individuals. Recent studies, however, highlight the role of photoageing, particularly from visible light exposure, as a significant contributing factor. Effective treatments for melasma and associated signs of photoageing remain a clinical challenge. This study aimed to evaluate the efficacy and safety of Poly-d,l-lactic acid (PDLLA) delivered via laser-induced microjet injectors in treating melasma and signs of photoageing. Eighteen Korean participants aged 42 to 74, with Fitzpatrick skin types III to IV, were enrolled. All participants exhibited melasma, signs of photoageing, or both. PDLLA was administered using the Mirajet device over 5 to 9 sessions. Clinical outcomes were assessed using the modified Melasma Area and Severity Index (MASI) and the Glogau Classification for photoageing. Adverse events were monitored throughout the study. Significant improvements were observed in both melasma severity and signs of photoageing. The mean MASI score decreased from 22.72 to 7.31 ( p =.004). Photoageing severity, as assessed by the Glogau Classification, also improved notably. Minimal side effects were reported, primarily transient bleeding. PDLLA administered via laser-induced microjet injectors appears to be a safe and effective treatment for melasma and photoageing, particularly in patients with more severe melasma. These findings suggest the potential for PDLLA in skin rejuvenation; however, further randomised controlled trials are warranted to confirm these results and optimise treatment protocols.

Abstract Photoaging pigmentation conditions such as senile lentigo and melasma show epidermal melanogenic activity and dermal abnormalities, including collagen degradation. A dermal rejuvenation strategy with skin‐lightening therapy directly acting on melanocytes is suggested for photoaging pigmentation. This study investigates whether collagen biostimulation can result in skin lightening of photoaging skin. A split‐face clinical trial was conducted, involving 40 subjects with facial melasma and senile lentigo. Subjects received a poly‐DL‐lactic acid (PDLLA) treatment on one side of their face, whereas the contralateral side received a treatment of normal saline as a control. Assessments were scheduled every month after completing treatments for up to 3 months. Pigmentation was evaluated using the L* value as measured with a chromameter and by investigator global assessment scores (IGA). Subjects reported different outcomes in terms of overall skin quality, including pigmentation, wrinkles and elasticity. Skin biopsies were obtained before the treatment and 4 weeks after completing the treatment. Fontana‐Masson, Masson‐Trichrome and Verhoeff‐van Gieson staining, and fibroblast‐specific protein 1 (FSP1) immunostaining were conducted. The PDLLA treatment demonstrated significant improvements in the L* values and IGA scores from 8 weeks after the subject completed their treatments. These improvements were sustained over a 12‐week assessment period. The subjects reported substantial reductions in both pigmentation and wrinkle severity and elasticity throughout the assessment period. Fontana‐Masson staining showed a marked decrease in pigmentation upon a PDLLA injection compared to the baseline values. Increased immunogenicity of FSP1 and increases in collagen and elastic fibre staining were observed. This study demonstrated remarkable improvements in photoaging pigmentation along with collagen production with a collagen biostimulator. Thus, collagen biostimulators represent a promising therapeutic approach for addressing photoaging signs associated with melasma and senile lentigo. (ClinicalTrials.gov Identifier: NCT05913102).

A laser-induced needle-free microjet injector was developed for rapid, high-speed drug delivery of microliters into the skin. This study evaluated the clinical rejuvenation effect of repeated dermal injections of the collagen simulator poly- dl -lactic acid (PDLA) using a laser-induced needle-free microjet injector. Five PDLA injection sessions using a laser-induced needle-free microjet injector were conducted in patients concerned about aging skin. Facial uplifting, darkness, redness, roughness, pore size, subjective satisfaction, and side effects were evaluated before each session and 4 weeks after treatment completion. Histological evaluation was also performed with immunohistochemical staining of collagen and elastic fibers. The clinical results of 27 female patients were evaluated. The treatment resulted in a noticeable skin surface uplifting (0.711 ± 0.42 mm) and significant improvements in darkness ( p = .013), redness ( p = .009), and roughness ( p = .036), with no significant difference in the pore size ( p = .770). Patients were reported being satisfied with the overall therapeutic effects, despite mild and tolerable adverse effects. Histological findings revealed growth and thickening of collagen and elastic fibers, with marked increase in collagen I and III levels. Repeated dermal injections of PDLA using a laser-induced microjet injector offer excellent drug delivery, achieving high efficacy in skin rejuvenation, patient satisfaction, and safety.