Sung Hee Lim

Objectives: Telepractice is the remote delivery of speech and language services via telecommunication systems. No meta-analysis has investigated the topic of treating children and adolescents with speech, language and hearing impairments via telepractice using a direct comparison of telepractice with face-to-face-service delivery. The purpose of this meta-analysis is to estimate the efficacy of telepractice in the treatment of speech, language & hearing impairments in children and adolescents. Methods: 10 studies which met the inclusive criteria were selected from 9 electronic databases (Academic Search Complete, PsycINFO, Eric, PubMed, CINAHL PLUS, Google Scholar, RISS, DBpia, Kyobo Scholar). A systematic review of literature was carried out using meta-analysis (Comprehensive Meta-Analysis version 2). Effect sizes were calculated using Hedges' g. Results: The analysis of the difference of mean effect sizes between telepractice and FTF intervention according to disorder types reveal that the intervention effect of FTF intervention was significantly larger than that of telepractice in speech sound disorders. Whereas in hearing impairments and ASD, there was no significant difference between the intervention effect of telepractice and that of FTF intervention. Also, the analysis of the difference of mean effect sizes according to treatment types reveal that there was no significant difference in the intervention effects of telepractice and FTF intervention in indirect treatment. Conclusion: When selecting a treatment method between telepractice and FTF intervention, the results of this meta-analysis suggests that the characteristics of participants such as age, type of speech-language disorders, severity of disorders and cognitive ability including attention should be considered comprehensively.

Few studies have investigated language recovery patterns and the mechanisms of crossed bilingual aphasia following a subcortical stroke. In particular, Korean-Japanese crossed bilingual aphasia has not been reported. A 47-year-old, right-handed man was diagnosed with an extensive right basal ganglia hemorrhage. He was bilingual, fluent in both Korean and Japanese. After his stroke, the patient presented with crossed aphasia. We investigated changes in the Korean (L1) and Japanese (L2) language recovery patterns. Both Korean and Japanese versions of the Western Aphasia Battery (WAB) were completed one month after the stroke, and functional magnetic resonance imaging (fMRI) was performed using picture-naming tasks. The WAB showed a paradoxical pattern of bilingual aphasia, with an aphasia quotient (AQ) of 32 for Korean and 50.6 for Japanese, with Broca's aphasia. The patient scored better in the Japanese version of all domains of the tests. The fMRI study showed left lateralized activation in both language tasks, especially in the inferior frontal gyrus. After six months of language therapy targeting L1, the Korean-WAB score improved significantly, while the Japanese-WAB score showed slight improvement. In this case, the subcortical lesion contributed to crossed bilingual aphasia more highly affecting L1 due to loss of the cortico-subcortical control mechanism in the dominant hemisphere. The paradoxical pattern of bilingual aphasia disappeared after lengthy language therapy targeting L1, and the therapy effect did not transfer to L2. Language recovery in L1 might have been accomplished by reintegrating language networks, including the contralesional language homologue area in the left hemisphere.

Sunghee Lim, M.A.*, Miseon Kwon, Ph.D.†, Hyun-Sub Sim, Ph.D.‡, SangYun Kim, M.D., Jun-Young Lee, M.D. Department of Physical Medicine and Rehabilitation*, Korea University Anam Hospital, Seoul; Department of Neurology†, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Department of Communication Disorders‡, Ewha Womans University, Seoul; Department of Neurology§, Seoul National University College of Medicine & Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea

BACKGROUND Bevacizumab, an anti-vascular endothelial growth factor (VEGF) monoclonal antibody, inhibits angiogenesis and reduces tumor growth. Serum VEGF-C, lactate dehydrogenase, and inflammatory markers have been reported as predictive markers related to bevacizumab treatment. Programmed cell death ligand 1 (PD-L1) could act upon VEGF receptor 2 to induce cancer cell angiogenesis and metastasis. AIM To investigate the efficacy of bevacizumab-containing chemotherapy in patients with metastatic colorectal cancer (CRC) according to the expression of PD-L1. METHODS This analysis included CRC patients who received bevacizumab plus FOLFOX or FOLFIRI as first-line therapy between June 24, 2014 and February 28, 2022, at Samsung Medical Center (Seoul, South Korea). Analysis of patient data included evaluation of PD-L1 expression by the combined positive score (CPS). We analyzed the efficacy of bevacizumab according to PD-L1 expression status in patients with CRC. RESULTS A total of 124 patients was included in this analysis. Almost all patients were treated with bevacizumab plus FOLFIRI or FOLFOX as the first-line chemotherapy. While 77% of patients received FOLFOX, 23% received FOLFIRI as backbone first-line chemotherapy. The numbers of patients with a PD-L1 CPS of 1 or more, 5 or more, or 10 or more were 105 (85%), 64 (52%), and 32 (26%), respectively. The results showed no significant difference in progression-free survival (PFS) and overall survival (OS) with bevacizumab treatment between patients with PD-L1 CPS less than 1 and those with PD-L1 CPS of 1 or more (PD-L1 < 1% vs PD-L1 ≥ 1%; PFS: P = 0.93, OS: P = 0.33), between patients with PD-L1 CPS less than 5 and of 5 or more (PD-L1 < 5% vs PD-L1 ≥ 5%; PFS: P = 0.409, OS: P = 0.746), and between patients with PD-L1 CPS less than 10 and of 10 or more (PD-L1 < 10% vs PD-L1 ≥ 10%; PFS: P = 0.529, OS: P = 0.568). CONCLUSION Chemotherapy containing bevacizumab can be considered as first-line therapy in metastatic CRC irrespective of PD-L1 expression.