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      • KCI등재

        The Chinese Black Box - A Scientific Model of Traditional Chinese Medicine

        Theodorou, Matthias,Fleckenstein, Johannes Korean AcupunctureMoxibustion Medicine Society 2019 대한침구의학회지 Vol.30 No.1

        Models of traditional Chinese medicine (TCM) are still difficult to grasp from the view of a Western-cultural background. For proper integration into science and clinical research, it is vital to think "out of the box" of classical sciences. Modern sciences, such as quantum physics, system theory, and information theory offer new models, that reveal TCM as a method to process information. For this purpose, we apply concepts of information theory to propose a "Chinese black box model," that allows for a non-deterministic, bottom-up approach. Considering a patient as an undeterminable complex system, the process of getting information about an individual in Chinese diagnostics is compared to the input-process-output principle of information theory and quantum physics, which is further illustrated by Wheeler's "surprise 20 questions." In TCM, an observer uses a decision-making algorithm to qualify diagnostic information by the binary polarities of "yang" (latin activity) and "yin" (latin structivity) according to the so called "8 principles" (latin 8 guiding criteria). A systematic reconstruction of ancient Chinese terms and concepts illuminates a scattered scientific method, which is specified in a medical context by Latin terminology of the sinologist Porkert [definitions of the Latin terms are presented in Porkert's appendix [1] (cf. Limitations)].

      • KCI등재

        The Chinese Black Box – A Scientific Model of Traditional Chinese Medicine

        Matthias Theodorou,Johannes Fleckenstein 대한침구의학회 2019 대한침구의학회지 Vol.36 No.1

        Models of traditional Chinese medicine (TCM) are still difficult to grasp from the view of a Western-cultural background. For proper integration into science and clinical research, it is vital to think “out of the box” of classical sciences. Modern sciences, such as quantum physics, system theory, and information theory offer new models, that reveal TCM as a method to process information. For this purpose, we apply concepts of information theory to propose a “Chinese black box model,” that allows for a non-deterministic, bottom-up approach. Considering a patient as an undeterminable complex system, the process of getting information about an individual in Chinese diagnostics is compared to the input-process-output principle of information theory and quantum physics, which is further illustrated by Wheeler’s “surprise 20 questions.” In TCM, an observer uses a decision-making algorithm to qualify diagnostic information by the binary polarities of “yang” (latin activity) and “yin” (latin structivity) according to the so called “8 principles” (latin 8 guiding criteria). A systematic reconstruction of ancient Chinese terms and concepts illuminates a scattered scientific method, which is specified in a medical context by Latin terminology of the sinologist Porkert [definitions of the Latin terms are presented in Porkert’s appendix [1] (cf. Limitations)].

      • KCI등재

        Can ultra-low-dose computed tomography reliably diagnose and classify maxillofacial fractures in the clinical routine?

        Widmann Gerlig,Dangl Marcel,Lutz Elisa,Fleckenstein Bernhard,Offermanns Vincent,Offermanns Vincent,Puelacher Wolfgang,Salbrechter Lukas 대한영상치의학회 2023 Imaging Science in Dentistry Vol.53 No.1

        Purpose: Maxillofacial trauma predominantly affects young adults between 20 and 40 years of age. Although radioprotection is a legal requirement, the significant potential of dose reduction in computed tomography (CT) is still underused in the clinical routine. The objective of this study was to evaluate whether maxillofacial fractures can be reliably detected and classified using ultra-low-dose CT. Materials and Methods: CT images of 123 clinical cases with maxillofacial fractures were classified by two readers using the AOCOIAC software and compared with the corresponding results from post-treatment images. In group 1, consisting of 97 patients with isolated facial trauma, pre-treatment CT images at different dose levels (volumetric computed tomography dose index: ultra-low dose, 2.6 mGy; low dose, <10 mGy; and regular dose, <20 mGy) were compared with post-treatment cone-beam computed tomography (CBCT). In group 2, consisting of 31 patients with complex midface fractures, pre-treatment shock room CT images were compared with post-treatment CT at different dose levels or CBCT. All images were presented in random order and classified by 2 readers blinded to the clinical results. All cases with an unequal classification were re-evaluated. Results: In both groups, ultra-low-dose CT had no clinically relevant effect on fracture classification. Fourteen cases in group 2 showed minor differences in the classification code, which were no longer obvious after comparing the images directly to each other. Conclusion: Ultra-low-dose CT images allowed the correct diagnosis and classification of maxillofacial fractures. These results might lead to a substantial reconsideration of current reference dose levels.

      • KCI등재

        Prosthetic shoulder arthroplasty in patients 40 years or younger: outcomes stratified by diagnosis and surgery

        Samer S. Hasan,Leslie E. Schwindel,Cassie M. Fleckenstein 대한견주관절의학회 2022 대한견주관절의학회지 Vol.25 No.4

        Background: The outcomes of patients 50–55 years old or younger undergoing prosthetic shoulder arthroplasty (PSA) may not generalize to younger patients. We report outcomes following PSA in a consecutive series of patients 40 years or younger. We hypothesize that total shoulder arthroplasty (TSA) provides better outcome and durability than resurfacing hemiarthroplasty (RHA). Methods: Patients were stratified by diagnosis and surgical procedure performed, RHA or TSA. Active range of motion and self-assessed outcome were evaluated preoperatively and at final follow-up. Results: Twenty-nine consecutive PSAs were identified in 26 patients, comprising 9 TSAs and 20 RHAs, with a minimum of 2-year follow-up. Twelve PSAs were performed for chondrolysis. Mean active forward elevation, abduction, external rotation, and internal rotation improved significantly (p<0.001 for all). Mean pain score improved from 6.3 to 2.1, Simple Shoulder Test from 4.0 to 9.0, and American Shoulder and Elbow Surgeons score from 38 to 75 (p<0.001 for all). Patients undergoing RHA and TSA had similar outcomes; but three RHAs required revision, two of these within 4 years of implantation. Four of five patients undergoing revision during the study period had an original diagnosis of chondrolysis. Conclusions: PSA in young patients provides substantial improvement in active range of motion and patient reported outcomes irrespective of diagnosis and glenoid management. However, patients undergoing RHA, especially for chondrolysis, frequently require subsequent revision surgery, so that RHA should be considered with caution in young patients and only after shared decision-making and counsel on the risk of early revision to TSA.

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