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Bang WS, Han I, Mun SA, Hwang JM, Noh SH, Son W, Cho DC, Kim BJ, Kim CH, Choi H, Kim KT. Electrical stimulation promotes functional recovery after spinal cord injury by activating endogenous spinal cord-derived neural stem/progenitor cell: an in vitro and in vivo study. Spine J 2024; 24:534-553. [PMID: 37871660 DOI: 10.1016/j.spinee.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 09/15/2023] [Accepted: 10/14/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND CONTEXT Electrical stimulation is a noninvasive treatment method that has gained popularity in the treatment of spinal cord injury (SCI). Activation of spinal cord-derived neural stem/progenitor cell (SC-NSPC) proliferation and differentiation in the injured spinal cord may elicit considerable neural regenerative effects. PURPOSE This study aimed to explore the effect of electrical stimulation on the neurogenesis of SC-NSPCs. STUDY DESIGN This study analyzed the effects of electrical stimulation on neurogenesis in rodent SC-NSPCs in vitro and in vivo and evaluated functional recovery and neural circuitry improvements with electrical stimulation using a rodent SCI model. METHODS Rats (20 rats/group) were assigned to sham (Group 1), SCI only (Group 2), SCI + electrode implant without stimulation (Group 3), and SCI + electrode with stimulation (Group 4) groups to count total SC-NSPCs and differentiated neurons and to evaluate morphological changes in differentiated neurons. Furthermore, the Basso, Beattie, and Bresnahan scores were analyzed, and the motor- and somatosensory-evoked potentials in all rats were monitored. RESULTS Biphasic electrical currents enhanced SC-NSPC proliferation differentiation and caused qualitative morphological changes in differentiated neurons in vitro. Electrical stimulation promoted SC-NSPC proliferation and neuronal differentiation and improved functional outcomes and neural circuitry in SCI models. Increased Wnt3, Wnt7, and β-catenin protein levels were also observed after electrical stimulation. CONCLUSIONS Our study proved the beneficial effects of electrical stimulation on SCI. The Wnt/β-catenin pathway activation may be associated with this relationship between electrical stimulation and neuronal regeneration after SCI. CLINICAL SIGNIFICANCE The study confirmed the benefits of electrical stimulation on SCI based on cellular, functional, electrophysiological, and histological evidence. Based on these findings, we expect electrical stimulation to make a positive and significant difference in SCI treatment strategies.
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Affiliation(s)
- Woo-Seok Bang
- Department of Neurosurgery, Topspine Hospital, Daegu, Republic of Korea.
| | - Inbo Han
- Department of Neurosurgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
| | - Seul-Ah Mun
- Department. of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea.
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea.
| | - Sung Hyun Noh
- Department of Neurosurgery, Ajou University School of Medicine, Suwon, Republic of Korea.
| | - Wonsoo Son
- Department. of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea.
| | - Dae-Chul Cho
- Department. of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea.
| | - Byoung-Joon Kim
- Department. of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea.
| | - Chi Heon Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Hyuk Choi
- Department of Medical Sciences, Graduate School of Medicine, Korea University, Seoul, Republic of Korea.
| | - Kyoung-Tae Kim
- Department. of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea.
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Ko Y, Hwang JM, Baek SH. Discharge transitional care programme for older adults after hip fracture surgery: a quasi-experimental study. J Res Nurs 2023; 28:582-593. [PMID: 38162723 PMCID: PMC10756176 DOI: 10.1177/17449871231204499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Background Hip fractures require extended periods of recovery and rehabilitation, subjecting older adults to discontinuous care. Discharge transition is a critical point of heightened vulnerability for older adults. Aims This study aimed to evaluate the effectiveness of a transitional care programme on the physical functions and quality of life (QOL) of older adults after hip fracture surgery. Methods Seventy-five older adults were assessed from pre-discharge to 6 weeks after hip surgery, and their physical functions, including walking status and activities of daily living, were measured. The QOL was measured using the European Quality of life-5 Dimensions-5 Levels (EQ 5D 5L). Results There was a significant strong effect of time (B = 10.565; 95% CI = 2.584-18.547; p = 0.009) on the EuroQol Visual Analog Scale (EQ-VAS) for the experimental group. However, there were no significant effects of time on physical functions and EQ-5D-5L scores. Conclusions The discharge transitional care programme improved the EQ-VAS of older adults following hip fracture surgery 6 weeks post-surgery. However, there were no significant differences in physical functions and EQ-5D between the groups.
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Affiliation(s)
- YoungJi Ko
- Associate Professor, Department of Nursing, Daegu Haany University, South Korea
| | - Jong-Moon Hwang
- Assistant Professor, Department of Rehabilitation Medicine, Kyungpook National University Hospital, South Korea
| | - Seung-Hoon Baek
- Associate Professor, Department of Orthopedic Surgery, Kyungpook National University Hospital, South Korea
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Ahn CH, Kang S, Cho M, Kim SH, Kim CH, Han I, Kim CH, Noh SH, Kim KT, Hwang JM. Comparing zero-profile and conventional cage and plate in anterior cervical discectomy and fusion using finite-element modeling. Sci Rep 2023; 13:15766. [PMID: 37737299 PMCID: PMC10516908 DOI: 10.1038/s41598-023-43086-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 09/19/2023] [Indexed: 09/23/2023] Open
Abstract
Conventional cage and plate (CCP) implants usually used in ACDF surgery, do have limitations such as the development of postoperative dysphagia, adjacent segment degeneration, and soft tissue injury. To reduce the risk of these complications, zero-profile stand-alone cage were developed. We used finite-element modeling to compare the total von Mises stress applied to the bone, disc, endplate, cage and screw when using CCP and ZPSC implants. A 3-dimensional FE (Finite element) analysis was performed to investigate the effects of the CCP implant and ZPSC on the C3 ~ T1 vertebrae. We confirmed that the maximum von Mises stress applied with ZPSC implants was more than 2 times greater in the endplate than that applied with CCP implants. The 3D analysis of the ZPSC model von Mises stress measurements of screw shows areas of higher stress in red. Although using ZPSC implants in ACDF reduces CCP implant-related sequalae such as dysphagia, we have shown that greater von Mises stress is applied to the endplate, and screw when using ZPSC implants. This may explain the higher subsidence rate associated with ZPSC implant use in ACDF. When selecting an implant in ACDF, surgeons should consider patient characteristics and the advantages and disadvantages of each implant type.
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Affiliation(s)
- Chang-Hwan Ahn
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, 41944, Republic of Korea
| | - Sungwook Kang
- Precision Mechanical Process and Control R&D Group, Korea Institute of Industrial Technology, Jinju-si, Gyeongsangnam-do, 52845, Republic of Korea
| | - Mingoo Cho
- Precision Mechanical Process and Control R&D Group, Korea Institute of Industrial Technology, Jinju-si, Gyeongsangnam-do, 52845, Republic of Korea
| | - Seong-Hun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, 41944, Republic of Korea
| | - Chi Heon Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Inbo Han
- Department of Neurosurgery, CHA University, School of Medicine, CHA Bundang Medical Center, Seongnam, Republic of Korea
| | - Chul-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, 41944, Republic of Korea
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea
| | - Sung Hyun Noh
- Department of Neurosurgery, Ajou University College of Medicine, Suwon, Republic of Korea
| | - Kyoung-Tae Kim
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, 41944, Republic of Korea.
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea.
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, 41944, Republic of Korea.
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea.
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Cho M, Han JS, Kang S, Ahn CH, Kim DH, Kim CH, Kim KT, Kim AR, Hwang JM. Biomechanical Effects of Different Sitting Postures and Physiologic Movements on the Lumbar Spine: A Finite Element Study. Bioengineering (Basel) 2023; 10:1051. [PMID: 37760153 PMCID: PMC10525568 DOI: 10.3390/bioengineering10091051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/30/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
This study used the finite element method(FEM) to investigate how pressure on the lumbar spine changes during dynamic movements in different postures: standing, erect sitting on a chair, slumped sitting on a chair, and sitting on the floor. Three load modes (flexion, lateral bending, and axial rotation) were applied to the FEM, simulating movements of the lumbar spine. Results showed no significant difference in pressure distribution on the annulus fiber and nucleus pulposus, representing intradiscal pressure, as well as on the cortical bone during movements between standing and erect sitting postures. However, both slumped sitting on a chair and sitting on the floor postures significantly increased pressure on the nucleus pulposus, annulus fibrosus, and cortical bone in all three movements when compared to standing or erect sitting on a chair. Notably, sitting on the floor resulted in even higher pressure on the nucleus pulposus and annulus fibers compared to slumped sitting on a chair. The decreased lumbar lordosis while sitting on the floor led to the highest increase in pressure on the annulus fiber and nucleus pulposus in the lumbar spine. In conclusion, maintaining an erect sitting position with increased lumbar lordosis during seated activities can effectively reduce intradiscal pressure and cortical bone stress associated with degenerative disc diseases and spinal deformities.
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Affiliation(s)
- Mingoo Cho
- Precision Mechanical Process and Control R&D Group, Korea Institute of Industrial Technology, Jinju-si 52845, Republic of Korea; (M.C.); (S.K.)
| | - Jun-Sang Han
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea; (J.-S.H.); (C.-H.A.); (C.-H.K.)
| | - Sungwook Kang
- Precision Mechanical Process and Control R&D Group, Korea Institute of Industrial Technology, Jinju-si 52845, Republic of Korea; (M.C.); (S.K.)
| | - Chang-Hwan Ahn
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea; (J.-S.H.); (C.-H.A.); (C.-H.K.)
| | - Dong-Hee Kim
- Department of Orthopaedic Surgery, Gyeongsang National University, College of Medicine, Jinju-si 52727, Republic of Korea;
| | - Chul-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea; (J.-S.H.); (C.-H.A.); (C.-H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Kyoung-Tae Kim
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu 41944, Republic of Korea;
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Ae-Ryoung Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea; (J.-S.H.); (C.-H.A.); (C.-H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea; (J.-S.H.); (C.-H.A.); (C.-H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
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Park SJ, Hwang JM, Cho DC, Lee S, Kim CH, Han I, Park DW, Kwon HD, Kim KT. Indirect Decompression Using Oblique Lumbar Interbody Fusion Revision Surgery Following Previous Posterior Decompression: Comparison of Clinical and Radiologic Outcomes Between Direct and Indirect Decompression Revision Surgery. Neurospine 2022; 19:544-554. [PMID: 36203280 PMCID: PMC9537844 DOI: 10.14245/ns.2244242.121] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 06/02/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE This study compared the radiological and clinical outcomes with transforaminal lumbar interbody fusion (TLIF) to evaluate the effect of indirect decompression through oblique lumbar interbody fusion (OLIF) as revision surgery. METHODS We enrolled patients who underwent single-level fusion with revision surgery at the same level as the previous decompression level. We retrospectively reviewed 25 patients who underwent OLIF from 2017 to 2018 and 25 who received TLIF from 2014 to 2018. Radiologic and clinical outcomes were evaluated by cross-sectional area (CSA) of the spinal canal, thickness and area of ligamentum flavum (LF), subsidence, disc height, fusion rate, Oswestry Disability Index (ODI), and visual analogue scale (VAS). RESULTS Compared with OLIF, the thickness and area of the LF after surgery were significantly less in TLIF, and the resulting CSA extension was also significantly higher. However, both groups showed improvement in ODI and VAS after surgery, and there was no difference between the groups. Complications related to the posterior approach in TLIF were 4 cases, and in OLIF, there were 2 cases that underwent additional posterior decompression surgery and 6 cases of transient paresthesia. CONCLUSION Since complications associated with the posterior approach can be avoided, OLIF is a safer and useful minimally invasive surgery. Therefore, appropriate indications are applied, OLIF is a good alternative to TLIF when revision surgery is considered.
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Affiliation(s)
- Sang-Jin Park
- Department of Neurosurgery, Charmjoeun Spine and Joint Hospital, Daegu, Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
| | - Dae-Chul Cho
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
| | - Subum Lee
- Department of Neurosurgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chi Heon Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea,Department of Neurosurgery and Medical Device Development, Seoul National University College of Medicine, Seoul, Korea
| | - Inbo Han
- Department of Neurosurgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Dae-Won Park
- Department of Neurosurgery, Good Moonhwa Hospital, Busan, Korea
| | - Heum-Dai Kwon
- Department of Neurosurgery, Pohang Stroke and Spine Hospital, Pohang, Korea,Co-corresponding Author: Heum-Dai Kwon Department of Neurosurgery, Pohang Stroke and Spine Hospital, 352, Huimangdaero, Nam-gu, Pohang 37659, Korea ,
| | - Kyoung-Tae Kim
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea,Corresponding Author Kyoung-Tae Kim Department of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea ,
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Lee SJ, Kim MG, Kim JH, Min YS, Kim CH, Kim KT, Hwang JM. Factor Analysis Affecting Degree of Depression in Family Caregivers of Patients with Spinal Cord Injury: A Cross-Sectional Pilot Study. Int J Environ Res Public Health 2022; 19:10878. [PMID: 36078592 PMCID: PMC9517793 DOI: 10.3390/ijerph191710878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
This study was conducted to determine the degree of depression in family caregivers of spinal-cord-injury patients and to identify factors influencing family caregivers' depression. The final study subjects were 30 (family caregivers: 6 males and 24 females). The CES-D of family caregivers; general characteristics of spinal-cord-injury patients and family caregivers; and information on physical health, household income, leisure, social activity, family relationship, and life-in-general status of family caregiver were collected. A frequency analysis, normality test, Mann-Whitney test, Kruskal-Wallis test, Spearman Correlation analysis, hierarchical regression analysis, and spider network through a path model analysis were performed. As for the general characteristics, when the patient was economically active, the caregiver's depression was mean ± SD; 2.04 ± 0.71; otherwise, it was mean ± SD 2.86 ± 0.74, indicating that the caregiver of the non-economic activity patient was more depressed (p = 0.013). In Model 1 of the multiple regression analysis to understand the effect on the depression of the caregiver, it was confirmed that the depression of the caregiver decreased as the family caregiver had more leisure and social activities (B = -0.718, p = 0.001). In Model 2, it was found that the depression of caregivers increased when the patient did not engage in economic activity (B = 0.438, p = 0.016). In the spider-web form through the path model analysis, as the family's economic level increased, physical health increased by B = 0.755 (p < 0.001), and the increase in physical health (B = 0.424, p = 0.042) was, in turn, a factor in the increase of engagement in leisure and social activities. Various policies will be needed for the successful return to society of spinal-cord-injury patients by ensuring that their leisure and social activities and establishing measures to support their economical income.
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Affiliation(s)
- Su-Jin Lee
- Graduate School of Public Health, Kyungpook National University, Daegu 41944, Korea
| | - Myung-Gwan Kim
- Department of Biomedical Informatics, CHA University School of Medicine, Seongnam 13415, Korea
- Institute for Biomedical Informatics, CHA University School of Medicine, Seongnam 13415, Korea
| | - Jung hee Kim
- College of Pharmacy, Industrial Pharmacy, Chungbuk National University, Cheongju-si 28644, Korea
| | - Yu-Sun Min
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
- Department of Rehabilitation Medicine, Kyungpook National University Chilgok Hospital, Daegu 41404, Korea
| | - Chul-Hyun Kim
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea
| | - Kyoung-Tae Kim
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu 41944, Korea
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea
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Lee SJ, Lim MG, Kim JH, Park C, Ko Y, Kim MG, Kim CH, Kim A, Hwang JM. Physical Activity and Quality of Life in Adult Men and Women with Distorted Perception of Weight Status: Nationwide Surveys (KNHANES 2016-2018). Int J Environ Res Public Health 2022; 19:10417. [PMID: 36012050 PMCID: PMC9408130 DOI: 10.3390/ijerph191610417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
This study analyzed the distorted perception of weight in adults aged 20 years or older and investigated the difference in the amount of physical activity and health-related quality of life (HRQOL). This study examined 21,326 adults regarding their body mass index (BMI), subjective body recognition (SBR), physical activity (according to the Global Physical Activity Questionnaire; GPAQ), and HRQOL (EuroQol-5 Dimension; EQ-5D) from the 7th Korea National Health and Nutrition Examination Survey (2016−2018). Independent t-test, analysis of variance (ANOVA), chi-square test, and multiple regression analysis were conducted. The group with the same BMI and SBR significantly showed a long time of activity vigorous-intensity (F = 21.25, p = 0.003) and moderate-intensity time (F = 17.24, p < 0.001). In the ‘BMI = SBR’ group, the sub-group with normal BMI and normal SBR showed the highest vigorous-intensity (mean ± SD = 7.20 ± 26.05, F = 37.86, p < 0.001) and moderate-intensity (mean ± SD = 13.89 ± 30.18, F = 43.27, p < 0.001) activity times. The sub-group with normal BMI and normal SBR had the highest percentage of responding as normal in the five EQ-5D sub-items. For the score of the EQ-5D Index, the highest score was shown in the group that felt subjectively more obese than the actual BMI (F = 56.83, p < 0.001). In the ‘BMI = SBR’ group, these factors related to physical activity (vigorous-intensity, moderated-intensity, and walking) are factors influencing health-related quality of life in this regression model (F = 396.57, p < 0.001, R2 = 0.165). Various health promotion programs and policy recommendations to reduce the distorted perception of weight are required.
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Affiliation(s)
- Su-Jin Lee
- Graduate School of Public Health, Kyungpook National University, Daegu 41944, Korea
| | - Min-Gyu Lim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea
| | - Jung hee Kim
- College of Pharmacy, Industrial Pharmacy, Chungbuk National University, Cheongju-si 28644, Korea
| | - Chulyong Park
- Department of Occupational and Environmental Medicine, Yeungnam University Hospital, Daegu 42415, Korea
- Department of Preventive Medicine and Public Health, College of Medicine, Yeungnam University, Daegu 42415, Korea
| | - YoungJi Ko
- Department of Nursing, Daegu Hanny University, 1 Hanuidae-ro, Gyeongsan-si 38610, Korea
| | - Myung-Gwan Kim
- Department of Biomedical Informatics, CHA University School of Medicine, Seongnam 13415, Korea
- Institute for Biomedical Informatics, CHA University School of Medicine, Seongnam 13415, Korea
| | - Chul-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41566, Korea
| | - Aeryoung Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41566, Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea
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Lee SJ, Kim MG, Kim JH, Park C, Kim A, Hwang JM. Risk factors influencing COVID-19 mortality rate in OECD countries: A cross-sectional study. Medicine (Baltimore) 2022; 101:e29980. [PMID: 35984156 PMCID: PMC9387657 DOI: 10.1097/md.0000000000029980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The coronavirus disease (COVID-19) has spread globally; however, the COVID-19 mortality rate varies largely across countries. The purpose of this study was to investigate the factors affecting mortality and increase in mortality rate by time trends in 30 member countries of the Organization for Economic Co-operation and Development (OECD). These countries have different national health and medical characteristics in terms of health care use, health equipment, health resource, health risk, and health status at different time points. The results revealed that the lower 25% of countries had an increase in the mortality rate of 27.21% which was higher than the upper 25% of countries' increase in the mortality rate of 20.51%. Therefore, the affected countries should strengthen their medical infrastructure to prepare for such large-scale outbreaks in the future. It is imperative to reduce the health inequality between population groups and achieve health equity, regardless of the income gap, rather than vaccination of specific countries. This will require the management of non-communicable diseases, a solid health insurance system, a stable supply of medical supplies, and strengthening the competency of health care workers.
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Affiliation(s)
- Su-Jin Lee
- Graduate School of Public Health, Kyungpook National University
- Department of Nursing, Daegu Hanny University, Daegu, Korea
| | - Myung-Gwan Kim
- Department of Biomedical Informatics, CHA University School of Medicine, Seongnam, Korea
- Institute for Biomedical Informatics, CHA University School of Medicine, Seongnam, Korea
| | - Jung Hee Kim
- College of Pharmacy, Industrial Pharmacy, Chungbuk National University
| | - Chulyong Park
- Department of Occupational and Environmental Medicine, Yeungnam University Hospital, Daegu, Korea
- Department of Preventive Medicine and Public Health, College of Medicine, Yeungnam University, Daegu, Korea
| | - Aeryoung Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Jung-gu, Daegu, South Korea
- *Correspondence: Aeryoung Kim, Department of Rehabilitation Medicine, Kyungpook National University Hospital, Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, 700-721, 200 Dongduk-ro Jung-gu, Daegu, South Korea (e-mail: )
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
- *Correspondence: Aeryoung Kim, Department of Rehabilitation Medicine, Kyungpook National University Hospital, Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, 700-721, 200 Dongduk-ro Jung-gu, Daegu, South Korea (e-mail: )
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Jeong JG, Choi SH, Kim AR, Hwang JM. Gluteal Compartment Syndrome and Rhabdomyolysis after Prolonged Laparoscopic Nephroureterectomy and Treatment Strategies Including Rehabilitation: A Case Report. Healthcare (Basel) 2021; 10:healthcare10010047. [PMID: 35052211 PMCID: PMC8775820 DOI: 10.3390/healthcare10010047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/23/2021] [Accepted: 12/26/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Rhabdomyolysis is a clinical symptom caused by the rapid release of intracellular components such as myoglobin, lactate dehydrogenase, and creatine kinase into the blood circulation. It is commonly caused by muscular injury including compartment syndrome, infection, drugs, etc. Although it rarely occurs during surgery, the incidence may increase if risk factors such as long operation time, improper posture, and condition of being overweight exist. Case Presentation: A 46-year-old male patient complained of pain and weakness in the right hip area and several abnormal findings were observed in the blood sample, reflecting muscle injury and decreased renal function after prolonged urological surgery. He was confirmed as having rhabdomyolysis, which was caused by compartment syndrome of the right gluteal muscle. After the diagnosis, conservative cares were performed in the acute phase and rehabilitation treatments were performed in the chronic phase. After conservative treatment and rehabilitation, blood sample values returned to almost normal ranges and both level of pain and muscle strength were significantly improved. In addition, about 25 days after discharge, he almost recovered to pre-operative condition. Conclusion: Careful attention is required to prevent intraoperative compartment syndrome. It also suggests that not only medical treatment but also early patient-specific rehabilitation is important in patients with rhabdomyolysis after prolonged surgery.
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Affiliation(s)
- Jae-Gyeong Jeong
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (J.-G.J.); (A.-R.K.)
| | - Seock Hwan Choi
- Department of Urology, School of Medicine, Kyungpook National University, Daegu 41944, Korea;
| | - Ae-Ryoung Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (J.-G.J.); (A.-R.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (J.-G.J.); (A.-R.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
- Correspondence:
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Gwak DW, Hwang JM. Step-by-step inpatient rehabilitation for critical illness after coronavirus disease 2019: A CARE-compliant case report. Medicine (Baltimore) 2021; 100:e26317. [PMID: 34115043 PMCID: PMC8202574 DOI: 10.1097/md.0000000000026317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/17/2021] [Accepted: 05/25/2021] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Since the coronavirus disease (COVID-19) outbreak in Wuhan, China, in December 2019, COVID-19 has become a worldwide pandemic. Muscle weakness and deconditioning caused by COVID-19-induced critical illness requires rehabilitation. PATIENT CONCERNS A 74-year-old male patient complained of general weakness after COVID-19, requiring ventilator treatment. DIAGNOSIS He was confirmed as having COVID-19 using a polymerase chain reaction test. INTERVENTIONS During admission in the intensive care unit, medical staff wearing level D protective equipment performed the bedside manual range of motion exercise. After a negative COVID-19 test, the patient was transferred to a general ward, where sitting balance training and pulmonary rehabilitation were additionally performed by rehabilitation therapists wearing protective gear. When the patient was able to stand up with support, standing balance training and sit-to-stand training were performed. OUTCOMES After a month of rehabilitation, the patient could sit alone, but he needed help with standing balance. The Berg Balance Scale score improved from 0 to 4, and the Modified Barthel Index score improved from 8 to 18. He was able to breathe in room air without an oxygen supply. LESSONS This case report shows an example of how safe and effective rehabilitation can be provided to COVID-19 patients.
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Affiliation(s)
- Dae-Won Gwak
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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Gwak DW, Hwang JM, Kim AR, Park D. Does polydeoxyribonucleotide has an effect on patients with tendon or ligament pain?: A PRISMA-compliant meta-analysis. Medicine (Baltimore) 2021; 100:e25792. [PMID: 34106615 PMCID: PMC8133136 DOI: 10.1097/md.0000000000025792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 04/15/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Pain in the tendons or ligaments is extremely common, accounting for 30% of the causes of visiting general practitioners. Polydeoxyribonucleotide (PDRN) is emerging as a new treatment for musculoskeletal pain. However, the effects of PDRN in patients with tendon or ligament pain are unclear. Therefore, this study aimed to determine the impact of PDRN in patients with tendon or ligament pain through a meta-analysis. METHODS Electronic literature search of PubMed, Embase, SCOPUS, and Cochrane Library databases of all articles on PDRN treatment for patients with tendon or ligament pain published in the English language from inception until January 31, 2020. The search identified 262 citations. RESULTS One randomized controlled trial and 3 retrospective observational studies were included. Pain due to tendon or ligament disorders showed significant improvement after PDRN injection (standardized mean difference [SMD] = -1.43, 95% confidence interval [CI] = -1.80 to -1.06, P < .00001). In the subanalysis of patients with rotator cuff tendinopathy, rotator cuff tendinopathy-induced pain significantly improved (SMD = -2.34, 95% CI = -3.61 to -1.07, P = .0003) after PDRN injection. However, there was no difference in shoulder pain and disability index score and strength of shoulder abduction in patients with rotator cuff tendinopathy (shoulder pain and disability index score, SMD = 1.16, 95% CI = -1.20 to 3.52, P = .34; strength of shoulder abduction, SMD = 0.42, 95% CI = -0.03 to 0.88, P = .07). CONCLUSION Effective pain relief was achieved in patients with tendon or ligament disorders after PDRN injection. To more precisely determine this effect, a meta-analysis with a larger number of clinical trials is warranted.
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Affiliation(s)
- Dae-Won Gwak
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University
| | - Ae Ryoung Kim
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University
| | - Donghwi Park
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
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Jung SH, Hwang JM, Kim CH. Inversion Table Fall Injury, the Phantom Menace: Three Case Reports on Cervical Spinal Cord Injury. Healthcare (Basel) 2021; 9:healthcare9050492. [PMID: 33922070 PMCID: PMC8143462 DOI: 10.3390/healthcare9050492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/14/2021] [Accepted: 04/19/2021] [Indexed: 12/13/2022] Open
Abstract
Background: An inversion device, which is used to suspend one’s body and perform traction therapy, was introduced as an inversion table under the name of “Geokkuri” in South Korea. Fall injuries while hanging on inversion tables are among the most devastating spine injuries, as the likelihood of severe neurological sequelae such as tetraplegia increases. However, its enormous danger has been overlooked and this devastating injury has become a common clinical entity over time. The limited number of studies reported imply the lack of interest of researchers in these injuries. We reviewed three cases of spinal cord injury sustained on inversion tables in different environments and report the potential danger associated with the use of inversion tables to facilitate a safer exercise environment.
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Affiliation(s)
- Seung-Hwan Jung
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea;
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea;
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
- Correspondence: (J.-M.H.); (C.-H.K.)
| | - Chul-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea;
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
- Correspondence: (J.-M.H.); (C.-H.K.)
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Hwang JM, Jung H, Kim CH, Lee YS, Lee M, Hwang SY, Kim AR, Park D. Submandibular Push Exercise Using Visual Feedback from a Pressure Sensor in Patients with Swallowing Difficulties: A Pilot Study. Healthcare (Basel) 2021; 9:407. [PMID: 33916285 PMCID: PMC8065833 DOI: 10.3390/healthcare9040407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives: We aimed to determine the usefulness and effectiveness of a submandibular push exercise with visual feedback from a pressure sensor in patients with dysphagia through continuous exercise sessions. Methods: Twelve patients with dysphagia of various etiologies were included. A total of five exercise sessions (every 3 or 4 days) over three weeks were conducted. During the submandibular push exercise, patients were instructed to maintain a maximum force for 3 s, repeated for 1 min to measure the number of exercises, the maximum pressure, and the area of the pressure-time graph. We statistically compared the values of each exercise trial. Results: Among the 12 patients, eight completed the exercise sessions. As the number of exercise trials increased, the maximum pressure and the area in the pressure-time graph showed a significant increase compared to the previous attempt (p < 0.05). The maximum pressure and the area of the pressure-time graph improved from the first to the fourth session (p < 0.05). The values were maintained after the fourth session, and there was no significant difference between the fourth and the fifth exercise (p > 0.05). There was no significant difference between successful and non-successful groups, except for the Modified Barthel Index (p < 0.05). Conclusion: Through repetitive exercise training, the submandibular push exercise using visual feedback from a pressure sensor can be applied as an exercise method to strengthen swallowing related muscles, such as the suprahyoid and infrahyoid muscles. However, additional studies including more patients and a long-term study period are warranted to evaluate the effects of the exercise for improvement of dysphagia.
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Affiliation(s)
- Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (J.-M.H.); (H.J.); (C.-H.K.); (Y.-S.L.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Hyunwoo Jung
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (J.-M.H.); (H.J.); (C.-H.K.); (Y.-S.L.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Chul-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (J.-M.H.); (H.J.); (C.-H.K.); (Y.-S.L.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Yang-Soo Lee
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (J.-M.H.); (H.J.); (C.-H.K.); (Y.-S.L.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Myunghwan Lee
- Medical Device Development Center, Daegu-Gyeongbuk Medical Innovation Foundation, Daegu 41061, Korea; (M.L.); (S.Y.H.)
| | - Soo Yeon Hwang
- Medical Device Development Center, Daegu-Gyeongbuk Medical Innovation Foundation, Daegu 41061, Korea; (M.L.); (S.Y.H.)
| | - Ae-Ryoung Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (J.-M.H.); (H.J.); (C.-H.K.); (Y.-S.L.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Donghwi Park
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea
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Chang MC, Park S, Cho JY, Lee BJ, Hwang JM, Kim K, Park D. Comparison of three different types of exercises for selective contractions of supra- and infrahyoid muscles. Sci Rep 2021; 11:7131. [PMID: 33785793 PMCID: PMC8010107 DOI: 10.1038/s41598-021-86502-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 03/16/2021] [Indexed: 01/25/2023] Open
Abstract
Several exercise methods, such as the Shaker exercise, tongue press exercise, chin tuck against resistance (CTAR) exercise, and submandibular push exercise, have been introduced to strengthen the muscles involved in swallowing. In this study, we compared the effectiveness of the CTAR, submandibular push, and Shaker exercises for the induction of selective supra- and infrahyoid muscle contractions using surface electromyography (EMG). This study is a prospective non-randomized controlled study. Twenty-five healthy subjects and 20 patients experiencing swallowing difficulty were enrolled. During the three different types of exercises, the root mean square (RMS) values of the sternocleidomastoid (SCM), suprahyoid (anterior belly of the digastric and mylohyoid muscles), and infrahyoid (sternothyroid and thyrohyoid muscles) muscles were analyzed using surface EMG. Differences in the activity of swallowing muscles among the three different exercises were analyzed using one-way repeated measured analysis of variance. In terms of both the maximum and mean RMS values of the suprahyoid muscle, the submandibular push exercise showed a larger RMS value than the CTAR and Shaker exercises in healthy subjects (p < 0.05). In terms of both the maximum and mean RMS values of the suprahyoid muscle, the Shaker exercise and submandibular push exercise showed a larger RMS value than the CTAR exercise in patients with swallowing difficulty (p < 0.05). The submandibular push exercise may be effective as a swallowing muscle exercise owing to its superiority in inducing selective contractions of the supra- and infrahyoid muscles. The CTAR and Shaker exercises are also effective in this regard.
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Affiliation(s)
- Min Cheol Chang
- Department of Rehabilitation Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Sungwon Park
- Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - Joo Young Cho
- Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - Byung Joo Lee
- Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - KwanMyung Kim
- Graduate School of Creative Design Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Donghwi Park
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea.
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Ko Y, Hwang JM, Baek SH. The Development of a Mobile Application for Older Adults for Rehabilitation Instructions After Hip Fracture Surgery. Geriatr Orthop Surg Rehabil 2021; 12:21514593211006693. [PMID: 35186422 PMCID: PMC8848083 DOI: 10.1177/21514593211006693] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 03/09/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction: Older patients with hip fractures require a long time to rehabilitate and recover after surgery. Although effective discharge instructions for long-term recovery are important, the discharge instructions of most acute-care hospitals are often presented as a brochure, which is difficult for older adults to follow. The purpose of this study was to develop rehabilitation instructions in the form of a mobile application for the physical recovery of older adults after hip fracture surgery. Materials and Methods: A mobile application for rehabilitation instructions after hip fracture surgery was developed in ADDIE order of analysis, design, development, implementation, and evaluation. The contents of the mobile application composed of rehabilitative exercises, activities of daily living, pain and nutrition management, fall prevention, and hospital visits. Nine experts evaluated the application and SPSS version 23.0 program was used for data analysis. Results: In the mobile application evaluation by the experts, the average score of the contents was 2.22 out of 3 points. The average score of understanding was the highest at 2.42, while accuracy was the lowest at 2.00 in the contents. The average score of the interface design was 2.32 out of 3 points. The average score of consistency was the highest at 2.42, while design suitability was the lowest at 2.25 in the interface design. The experts perceived the mobile application as simple and easy to understand while also suggesting some improvements. Conclusion: The average scores were highest for understanding of contents and consistency of the interface design and lowest for accuracy of contents and design suitability of the interface design. The mobile application was easy to understand and had consistency in design.
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Affiliation(s)
- YoungJi Ko
- Department of Orthopedic Surgery, School of Medicine, Kyungpook National University, Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
| | - Seung-Hoon Baek
- Department of Orthopedic Surgery, School of Medicine, Kyungpook National University, Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Korea
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Lee SJ, Jung SI, Kim MG, Park E, Kim AR, Kim CH, Hwang JM, Jung TD. The Influencing Factors of Gender Differences on Mental Burdens in Young Physiotherapists and Occupational Therapist. Int J Environ Res Public Health 2021; 18:ijerph18062858. [PMID: 33799650 PMCID: PMC8000823 DOI: 10.3390/ijerph18062858] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 12/29/2022]
Abstract
Background: Gender differences in personal discrimination experience, burnout, and job stress among physiotherapists and occupational therapists are considered as associated factors of job loss, poor job quality, high turnover, and economic losses due to the outflow of medical personnel. Thus, the purpose of this study is to analyze the level of burnout, personal discrimination experience, and job stress according to gender differences for young physiotherapists and occupational therapists. Furthermore, we used regression analyses to determine the contribution of gender differences in personal discrimination experience and job stress to self-reported burnout, considering gender and two age groups (younger than 30 years old vs. 30 years old and over). Methods: A total of 325 professional physiotherapists and occupational therapists were part of this study (n = 325; male n = 131; female n = 194. Age: 20–29 years old, n = 178; ≥30 years old, n = 147). Data were collected using a questionnaire including our three study variables (scales: the Maslach Burnout Inventory (MBI), a modified version of the gender section of the Medical School Graduation Questionnaire from the Association of American Medical Colleges; and the Korean version of the Job Content Questionnaire (JCQ)). Further, data on socio-demographic factors, job-related factors, health-related factors, and subjective job satisfaction were also collected. Results: There were significant positive correlations between job stress and gender differences in personal discrimination experience and job stress and burnout in women 30 years old and over. Personal experience of gender discrimination (β = 0.179, p = 0.015) and job stress (β = 0.162, p = 0.028) explained a significant 42.4% of the variance in burnout in the case of younger female participants (20–29 years old). However, this model did not explain a significant amount of the variance in burnout in the case of younger male participants (R2 = 0.156, p = 0.072). Regarding participants aged 30 years and over, our results showed that only job stress (but no personal experience of gender discrimination) was a relevant predictor for both males (β = 0.471, p < 0.001) and females (β = 0.373, p = 0.001). Conclusion: In this study, female therapists showed higher levels of burnout than male therapists. In particular, personal discrimination experience and job stress significantly contributed to burnout in younger female therapists while job stress was the most relevant predictor variable of burnout for both males (under 30 years old and 30 years old and over) and females in their thirties and beyond. For young female physiotherapists and occupational therapists, safe working environments should be created to reduce work-related mental burdens. It is also necessary to consider policies and regulations that can prevent job stress for therapists and measures that can positively resolve the unavoidable job stress.
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Affiliation(s)
- Su-Jin Lee
- Graduate School of Public Health, Kyungpook National University, Daegu 41944, Korea; (S.-J.L.); (M.-G.K.)
| | - Sang In Jung
- Unit of Rehabilitation Therapy, Kyungpook National University Chilgok Hospital, Daegu 41404, Korea;
| | - Myung-Gwan Kim
- Graduate School of Public Health, Kyungpook National University, Daegu 41944, Korea; (S.-J.L.); (M.-G.K.)
- Clinical Omics Institute, School of Medicine, Hakjungdong Campus of Kyungpook National University, Daegu 41404, Korea
| | - Eunhee Park
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (E.P.); (A.-R.K.); (C.H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Jung-gu, Daegu 41944, Korea
| | - Ae-Ryoung Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (E.P.); (A.-R.K.); (C.H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Jung-gu, Daegu 41944, Korea
| | - Chul Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (E.P.); (A.-R.K.); (C.H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Jung-gu, Daegu 41944, Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (E.P.); (A.-R.K.); (C.H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Jung-gu, Daegu 41944, Korea
- Correspondence: (J.-M.H.); (T.-D.J.); Tel.: +82-10-4678-5400 (J.-M.H.); +82-10-8709-7161 (T.-D.J.); Fax: +82-53-423-0389 (J.-M.H. & T.-D.J.)
| | - Tae-Du Jung
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (E.P.); (A.-R.K.); (C.H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Jung-gu, Daegu 41944, Korea
- Correspondence: (J.-M.H.); (T.-D.J.); Tel.: +82-10-4678-5400 (J.-M.H.); +82-10-8709-7161 (T.-D.J.); Fax: +82-53-423-0389 (J.-M.H. & T.-D.J.)
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17
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Lee JT, Park E, Hwang JM, Jung TD, Park D. Machine learning analysis to automatically measure response time of pharyngeal swallowing reflex in videofluoroscopic swallowing study. Sci Rep 2020; 10:14735. [PMID: 32895465 PMCID: PMC7477563 DOI: 10.1038/s41598-020-71713-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 07/28/2020] [Indexed: 11/09/2022] Open
Abstract
To evaluate clinical features and determine rehabilitation strategies of dysphagia, it is crucial to measure the exact response time of the pharyngeal swallowing reflex in a videofluoroscopic swallowing study (VFSS). However, measuring the response time of the pharyngeal swallowing reflex is labor-intensive and particularly for inexperienced clinicians, it can be difficult to measure the brief instance of the pharyngeal swallowing reflex by VFSS. To accurately measure the response time of the swallowing reflex, we present a novel framework, able to detect quick events. In this study, we evaluated the usefulness of machine learning analysis of a VFSS video for automatic measurement of the response time of a swallowing reflex in a pharyngeal phase. In total, 207 pharyngeal swallowing event clips, extracted from raw VFSS videos, were annotated at the starting point and end point of the pharyngeal swallowing reflex by expert clinicians as ground-truth. To evaluate the performance and generalization ability of our model, fivefold cross-validation was performed. The average success rates of detection of the class “during the swallowing reflex” for the training and validation datasets were 98.2% and 97.5%, respectively. The average difference between the predicted detection and the ground-truth at the starting point and end point of the swallowing reflex was 0.210 and 0.056 s, respectively. Therefore, the response times during pharyngeal swallowing reflex are automatically detected by our novel framework. This framework can be a clinically useful tool for estimating the absence or delayed response time of the swallowing reflex in patients with dysphagia and improving poor inter-rater reliability of evaluation of response time of pharyngeal swallowing reflex between expert and unskilled clinicians.
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Affiliation(s)
- Jong Taek Lee
- Artificial Intelligence Application Research Section, Electronics and Telecommunications Research Institute (ETRI), Daegu, Republic of Korea
| | - Eunhee Park
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, 807 Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea.,Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, 807 Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea.,Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Tae-Du Jung
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, 807 Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea. .,Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
| | - Donghwi Park
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea.
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Chang MC, Hwang JM, Jeon JH, Kwak SG, Park D, Moon JS. Fasting Plasma Glucose Level Independently Predicts the Mortality of Patients with Coronavirus Disease 2019 Infection: A Multicenter, Retrospective Cohort Study. Endocrinol Metab (Seoul) 2020; 35:595-601. [PMID: 32842719 PMCID: PMC7520580 DOI: 10.3803/enm.2020.719] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has become a global pandemic, which prompts a consensus for the necessity to seek risk factors for this critical disease. Risk factors affecting mortality of the disease remain elusive. Diabetes and hyperglycemia are known to negatively affect a host's antiviral immunity. We evaluated the relationship between a history of diabetes, fasting plasma glucose (FPG) levels and mortality among severely ill patients with COVID-19. METHODS This was a retrospective cohort study that assessed 106 adult inpatients (aged ≥18 years) from two tertiary hospitals in Daegu, South Korea. The participants were transferred to tertiary hospitals because their medical condition required immediate intensive care. The demographic and laboratory data were compared between COVID-19 patients who survived and those who did not. RESULTS Compared with the survivor group, age, and the proportions of diabetes, chronic lung disease and FPG were significantly higher in the deceased group. In the Cox proportional hazards regression model for survival analysis, FPG level and age were identified as significant predictors of mortality (P<0.05). The threshold values for predicting high mortality were age >68 years and FPG of 168 mg/dL, respectively. Among those without diabetes, high FPG remained a significant predictor of mortality (P<0.04). CONCLUSION High FPG levels significantly predicted mortality in COVID-19, regardless of a known history of diabetes. These results suggest intensive monitoring should be provided to COVID-19 patients who have a high FPG level.
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Affiliation(s)
- Min Cheol Chang
- Department of Rehabilitation Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae-Han Jeon
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sang Gyu Kwak
- Department of Medical Statistics, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Donghwi Park
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
- Corresponding authors: Donghwi Park Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Dong-gu, Ulsan 44033, Korea Tel: +82-52-250-7222, Fax: +82-52-250-7228, E-mail:
| | - Jun Sung Moon
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
- Jun Sung Moon Department of Internal Medicine, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea Tel: +82-53-620-3825, Fax: +82-53-654-3486, E-mail:
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19
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Kim MG, Lee SJ, Park D, Kim CH, Lee KH, Hwang JM. Relationship between the actual fine dust concentration and media exposure that influenced the changes in outdoor activity behavior in South Korea. Sci Rep 2020; 10:12006. [PMID: 32686706 PMCID: PMC7371889 DOI: 10.1038/s41598-020-68580-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 06/29/2020] [Indexed: 11/09/2022] Open
Abstract
The one reason of the decrease of walking time for adults in South Korea among various factors is the sense of fear about fine dust sparked by media reports, which has created a negative perception of fine dust. This study aimed to assess the change in concentration of fine dust, as well as individuals' walking time and health status, in South Korea, and to investigate the relationship between the media reports on fine dust. Using the national government statistics data, we analyzed the relationship between walking time, concentration of fine dust, and amount of media reports on fine dust. From 2008 to 2017, the average walking time and PM10 levels decreased from 76.17 to 49.47 min and 52 to 45 μg/m3; whereas PM10 media frequency increased from 349 to 9,234. No positive correlation existed between walking time in South Korea and exposure to fine dust. However, media reports on fine dust increased steadily from 2012 and peaked in 2015. The decrease in average walking time in South Korea was due to the negative perception created by the increase in media reports on fine dust, rather than the increase in the actual concentration of fine dust.
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Affiliation(s)
- Myung-Gwan Kim
- Graduate School of Public Health, Kyungpook National University, Daegu, South Korea
| | - Su-Jin Lee
- Graduate School of Public Health, Kyungpook National University, Daegu, South Korea
| | - Donghwi Park
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, Ulsan, South Korea.,University of Ulsan College of Medicine, Dong-gu, Ulsan, South Korea
| | - Chul-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, 200 Dongduk-ro Jung-gu, Daegu, 700-721, South Korea.,Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, 200 Dongduk-ro Jung-gu, Daegu, 700-721, South Korea
| | - Ki- Hoon Lee
- Mompyeonhan Rehabilitation Clinic, Daegu, South Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, 200 Dongduk-ro Jung-gu, Daegu, 700-721, South Korea. .,Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, 200 Dongduk-ro Jung-gu, Daegu, 700-721, South Korea.
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Park S, Cho JY, Lee BJ, Hwang JM, Lee M, Hwang SY, Kim K, Lee KH, Park D. Effect of the submandibular push exercise using visual feedback from pressure sensor: an electromyography study. Sci Rep 2020; 10:11772. [PMID: 32678239 PMCID: PMC7366651 DOI: 10.1038/s41598-020-68738-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/24/2020] [Indexed: 11/10/2022] Open
Abstract
We developed a new exercise method called the submandibular push exercise that can strengthen the suprahyoid muscle by inducing only the motion of the hyoid bone without neck flexion. In this study, we aimed to investigate and compare the muscle activity of the suprahyoid and infrahyoid muscles in the course of performing three different swallowing exercises. Twenty healthy participants and fifteen patients with dysphagia were recruited. Each participant consecutively performed three exercises: Shaker, CTAR, and submandibular push exercises. To investigate muscle activation, surface electromyography was performed on the suprahyoid, infrahyoid, and SCM muscles, during the exercises. Root mean square (RMS) was measured. In healthy participants, the submandibular push exercise showed a significantly higher RMS value in the suprahyoid and infrahyoid muscles than the Shaker and CTAR exercises using repeated ANOVA with Tukey's post hoc test (p < 0.05). In patients with dysphagia, the submandibular push and Shaker exercises showed significantly higher RMS value in the suprahyoid and infrahyoid muscles than the CTAR exercise. However, no significant difference was found between the submandibular push and Shaker exercises. In both healthy and patients with dysphagia, the mean RMS values of the SCM muscles during the submandibular push exercise were significantly lower than those during the Shaker exercise using repeated ANOVA with Tukey's post hoc test (p < 0.05). In conclusion, considering the relatively superior selectiveness in suprahyoid and infrahyoid muscle contraction, the submandibular push exercise using visual feedback from pressure sensor could be an efficient supplementary exercise to the conventional swallowing muscle exercises. However, further studies may be necessary to confirm the improvement in swallowing difficulty.
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Affiliation(s)
- Sungwon Park
- Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - Joo Young Cho
- Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - Byung Joo Lee
- Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Myunghwan Lee
- Medical Device Development Center, Daegu-Gyeongbuk Medical Innovation Foundation, Daegu, Republic of Korea
| | - Soo Yeon Hwang
- Medical Device Development Center, Daegu-Gyeongbuk Medical Innovation Foundation, Daegu, Republic of Korea
| | - KwanMyung Kim
- Graduate School of Creative Design Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Ki Hoon Lee
- Mompyeonhan Rehabilitation Clinic, Daegu, Republic of Korea
| | - Donghwi Park
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea.
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Kim JH, Kim AR, Kim MG, Kim CH, Lee KH, Park D, Hwang JM. Burnout Syndrome and Work-Related Stress in Physical and Occupational Therapists Working in Different Types of Hospitals: Which Group Is the Most Vulnerable? Int J Environ Res Public Health 2020; 17:E5001. [PMID: 32664583 PMCID: PMC7399933 DOI: 10.3390/ijerph17145001] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/03/2020] [Accepted: 07/09/2020] [Indexed: 11/16/2022]
Abstract
Because of the nature of their work, physical and occupational therapists are at high risk of burnout, which is associated with decreased job satisfaction, medical errors, and mental wellbeing in healthcare professionals. To well manage and minimize potential impact of burnout, risk factors should be determined. This study examined burnout and job stress in physical and occupational therapists in various Korean hospital settings. Physical and occupational therapists from several rehabilitation facilities in South Korea completed a survey between March-May 2019. A set of questionnaires, including the Maslach Burnout Inventory and Job Content Questionnaire, were distributed to all participants. In total, 325 professionals (131 men and 194 women) were recruited. Burnout and work-related stress differed significantly according to several factors. Hospital size, gender, and age were the main contributory factors affecting at least two dimensions of the questionnaires. The more vulnerable group consisted of female therapists in their 20s at small- or medium-sized hospitals with low scores for quality of life. High levels of job stress and burnout were observed in female therapists in their 20s at small- or medium-sized hospitals. Hospitals and society should create suitable environments and understand the nature of therapists' work to improve healthcare.
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Affiliation(s)
- Ju-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (J.-H.K.); (A.-R.K.); (C.-H.K.)
| | - Ae-Ryoung Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (J.-H.K.); (A.-R.K.); (C.-H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Myung-Gwan Kim
- Graduate School of Public Health, Kyungpook National University, Daegu 41566, Korea;
| | - Chul-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (J.-H.K.); (A.-R.K.); (C.-H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Ki-Hoon Lee
- Mompyeonhan Rehabilitation Clinic, Daegu 42401, Korea;
| | - Donghwi Park
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Dong-gu, Ulsan 44033, Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea; (J.-H.K.); (A.-R.K.); (C.-H.K.)
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
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Hwang JM, Kim JH, Park JS, Chang MC, Park D. Neurological diseases as mortality predictive factors for patients with COVID-19: a retrospective cohort study. Neurol Sci 2020; 41:2317-2324. [PMID: 32643133 PMCID: PMC7342552 DOI: 10.1007/s10072-020-04541-z] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/21/2020] [Indexed: 01/26/2023]
Abstract
INTRODUCTION In the current study, we evaluated factors that increase the coronavirus disease (COVID-19) patient death rate by analyzing the data from two cohort hospitals. In addition, we studied whether underlying neurological diseases are risk factors for death. METHODS In this retrospective cohort study, we included 103 adult inpatients (aged ≥ 18 years). We evaluated differences in demographic data between surviving and non-surviving COVID-19 patients. RESULTS In a multivariate logistic analysis, age and the presence of chronic lung disease and Alzheimer's dementia (AD) were the only significant parameters for predicting COVID-19 non-survival (p < 0.05). However, hypertension, coronary vascular disease, dyslipidemia, chronic kidney disease, diabetes, and history of taking angiotensin II receptor blockers (ARBs) or angiotensin-converting enzyme (ACE) inhibitors, as well as nonsteroidal anti-inflammatory drugs (NSAIDs), were not significantly associated with the death of COVID-19 patients. The optimal cutoff value obtained from the maximum Youden index was 70 (sensitivity, 80.77%; specificity, 61.04%), and the odds ratio of non-survival increased 1.055 fold for every year of age. CONCLUSIONS Clinicians should closely monitor and manage the symptoms of COVID-19 patients who are over the age of 70 years or have chronic lung disease or AD.
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Affiliation(s)
- Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, South Korea.,Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Ju-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, South Korea
| | - Jin-Sung Park
- Department of Neurology, School of medicine, Kyungpook National University Chilgok hospital, Kyungpook National University, Daegu, Republic of Korea
| | - Min Cheol Chang
- Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea. .,Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University 317-1, Daemyungdong, Namku, Taegu, 705-717, Republic of Korea.
| | - Donghwi Park
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunghwndo-ro, Dong-gu, Ulsan, 44033, Republic of Korea.
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Lee JE, Kim JH, Park CH, Gwak DW, Kim CH, Park D, Hwang JM. Are safe guards at trampoline parks safe enough?: A case report on a complete spinal cord injury after diving into a trampoline park foam pit. Medicine (Baltimore) 2019; 98:e18137. [PMID: 31770249 PMCID: PMC6890358 DOI: 10.1097/md.0000000000018137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Recently, commercial indoor trampoline parks have been opened around the globe, and both the number of venues and the park users are increasing. Academic literatures have largely focused on home trampoline related injuries, and less is known about the injuries associated with trampoline parks due to the limited number of studies or cases reported. In this report, we present a complete spinal cord injury sustained at a commercial indoor trampoline park. PATIENT CONCERNS A 26-year old male developed tetraplegia after plainly jumping on the trampolines and diving into one of the foam pits head first. DIAGNOSIS C-spine CT revealed bilateral interfacetal dislocation on C6-7, and his C-spine MRI showed anterior translational injury at C6-7 with severe cord encroachment and complete discoligamentous complex disruption. He was diagnosed with complete spinal cord injury. INTERVENTIONS The patient underwent 30 minutes each of physical therapy and occupational therapy twice a day for a total of 25 days of in-patient rehabilitation. Interventions included tilt table, passive range of motion exercises, functional electrical stimulation, sitting balance training, upper extremity strengthening exercise, and hand manipulation exercises. OUTCOME Despite intensive rehabilitation and the patient's good spirit, there was no functional change in all physical examinations between evaluations at initial and at discharge. LESSONS In conclusion, we aim to alert the risks associated with improper use of trampolines, promote safer entertainment environment, and aid in developing mandatory safety measures. We hope to alert the risks associated with improper use of trampolines, promote safer entertainment environment, and aid in developing mandatory safety measures.
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Affiliation(s)
- Jae Eun Lee
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
| | - Ju Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
| | - Chan Hee Park
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
| | - Dae Won Gwak
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
| | - Chul-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University
| | - Donghwi Park
- Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University
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Lee JE, Kim JH, Lee SJ, Kim M, Nam TW, Kim CH, Jung TD, Hwang JM. Does nonexistent of your hands on the screen guarantee no radiation exposure to your body? - Study on exposure of the practitioner's hands to radiation during C-arm fluoroscopy-guided injections and effectiveness of a new shielding device. Medicine (Baltimore) 2019; 98:e17959. [PMID: 31725656 PMCID: PMC6867788 DOI: 10.1097/md.0000000000017959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Observational phantom study.This study aimed to evaluate the radiation exposure dose of practitioner's hands when performing C-arm guided procedures and to determine the usefulness of our newly designed radiation shielding device.C-arm guided procedures including lumbar transforaminal epidural steroid injections (TFESIs) are commonly used for pain control induced by lumbar radiculopathy. The practitioner's hands are vulnerable to radiation exposure because of the long exposure time and short distance from the radiation resource. No studies to date have reported the cumulative exposure of the physician's hands according to location and exposure time.Using a chest phantom irradiated with X-rays under lumbar TFESI conditions, cumulative scatter radiation dose was measured at 36 points using a dosimeter. The measurements were checked at 1, 3, 5, 10 minutes of radiation exposure. The experiment was repeated using our newly designed shielding device.Significant radiation accumulation was observed in the field where the practitioner's hands might be placed during C-arm guided procedures. The further the distance from the radiation resource and the shorter the exposure time, the smaller was the cumulative radiation expose dose. The new shielding device showed an excellent shielding rate (66.0%-99.9%) when the dosimeter was within the shielding range. However, at some points, increased accumulated radiation exposure dose was observed, although the dosimeter was within the range of the shielding device.To reduce radiation exposure of the practitioner's hands when performing C-arm-guided procedures, the radiation exposure time should be decreased and a greater distance from the radiation resource should be maintained. When using our shielding device, placing the hand close to the device surface and minimizing the time using fluoroscopy minimized the radiation exposure of the hand.
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Affiliation(s)
- Jae-Eun Lee
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
| | - Ju-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
| | - Su-Jin Lee
- Graduate School of Public Health, Kyungpook National University
| | - Mingeon Kim
- Department of Advanced Technology, Medical Imaging Team, Daegu-Gyeongbuk Medical Innovation Foundation, South Korea
| | - Tae-Woo Nam
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
| | - Chul Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University
| | - Tae-Du Jung
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University
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Kim JY, Hwang JM, Park JS, Park S, Lee BJ, Park D. Ultrasound-guided peri-brachial plexus polydeoxyribonucleotide injection for a patient with postherpetic brachial plexopathy: A case report. Medicine (Baltimore) 2019; 98:e16694. [PMID: 31374058 PMCID: PMC6709125 DOI: 10.1097/md.0000000000016694] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
RATIONALE Although most complications of herpes zoster (HZ) are associated with the spread of varicella-zoster virus from the initially involved sensory ganglion, motor nerve impairment, such as limb weakness, is a rare but severe complication that is difficult to treat. PATIENT CONCERN A 73-year-old female presented with sudden left upper limb pain and weakness after HZ. DIAGNOSIS Brachial plexopathy following HZ (postherpetic brachial plexopathy). INTERVENTION Despite alleviation of the vesicles with antiviral treatments, the left upper limb weakness and neuropathic pain did not improve. After obtaining patient's consent, ultrasound-guided polydeoxyribonucleotide (PDRN) injection was performed around the left brachial plexus. OUTCOMES The patient showed marked improvement in left arm pain from numerical rating scale (NRS) 9 to 4, 1 day after PDRN injection. Subsequently, the pain improved to NRS 3, and motor weakness improved to Medical Research Council grade 2 to 4. LESSONS PDRN can be considered a viable substitute for corticosteroid injection in treatment of motor weakness and neuropathic pain after HZ.
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Affiliation(s)
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital
| | - Jin-Sung Park
- Department of Neurology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok hospital
| | - Sungwon Park
- Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea
| | - Byung Joo Lee
- Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea
| | - Donghwi Park
- Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea
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Nam TW, Oh HM, Lee JE, Kim JH, Hwang JM, Park E, Jung TD. An unusual complication of sacral nerve root injury following bone marrow harvesting: a case report. BMC Cancer 2019; 19:347. [PMID: 30975123 PMCID: PMC6458794 DOI: 10.1186/s12885-019-5567-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 04/01/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hematopoietic stem cell transplantation (HSCT) remains an important therapeutic option for many hematologic malignancies. Bone marrow harvesting from an appropriate donor must be conducted for hematopoietic stem cell transplantation (HSCT). Many previous studies show complications of the recipient after hematopoietic stem cell transplantation (HSCT). However, complications of the donor after bone marrow harvesting are rare. We here report a unique case of a patient who developed sacral nerve root injury after bone marrow harvesting. CASE PRESENTATION A 26-year-old man was admitted to our medical center complaining of acute onset painful burning and tingling sensation at the left posterior thigh and calf. He was a bone marrow donor for his brother's bone marrow transplantation. He had underwent a bone marrow harvesting procedure two days before admission as a bone marrow donor, using both posterior superior iliac spine (PSIS) as the puncture site. Pelvic magnetic resonance image (MRI) showed enhancement around the left S2 nerve root in T1 and T2-weighted images. Nerve conduction studies (NCS) revealed normal conduction velocity and amplitude on both lower extremities. Electromyography (EMG) presented abnormal spontaneous activity and neurogenic motor unit potentials on the S2-innervated intrinsic foot muscle and gastrocnemius, soleus muscle on the left. The patient was treated with pregabalin for pain control. The patient was followed up after 3, 6, and 12 months. Neuropathic pain improved to Visual Analogue Scale (VAS) 1, and recovery state was confirmed by re-innervation patterns of motor unit potentials in electromyography. CONCLUSION Bone marrow harvesting is a relatively safe procedure. However, variable complications may occur. Accurate anatomical knowledge and carefulness are required to avoid sacral nerve root injury when performing the bone marrow harvesting procedure.
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Affiliation(s)
- Tae-Woo Nam
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea
| | - Hyun-Min Oh
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea
| | - Jae-Eun Lee
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea
| | - Ju-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea
| | - Eunhee Park
- Department of Rehabilitation Medicine, Kyungpook National University Medical Center, Daegu, South Korea.,Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, 807 Hoguk-ro, Buk-gu, Daegu, 41404, South Korea
| | - Tae-Du Jung
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea. .,Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, 807 Hoguk-ro, Buk-gu, Daegu, 41404, South Korea.
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Kim D, Hwang JM. The center of pressure and ankle muscle co-contraction in response to anterior-posterior perturbations. PLoS One 2018; 13:e0207667. [PMID: 30496202 PMCID: PMC6264860 DOI: 10.1371/journal.pone.0207667] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/05/2018] [Indexed: 12/14/2022] Open
Abstract
Though both contraction of agonist muscles and co-contraction of antagonistic muscle pairs across the ankle joint are essential to postural stability, they are perceived to operate independently of each other, In an antagonistic setup, agonist muscles contract generating moment about the joint, while antagonist muscles contract generating stiffness across the joint. While both work together in maintaining robustness in the face of external perturbations, contractions of agonist muscles and co-contractions of antagonistic muscle pairs across the ankle joint play different roles in responding to and adapting to external perturbations. To determine their respective roles, we exposed participants to repeated perturbations in both large and small magnitudes. The center of pressure (COP) and a co-contraction index (CCI) were used to quantify the activation of agonist muscles and antagonistic muscle pairs across the ankle joint. Our results found that participants generated moment of a large magnitude across the ankle joint—a large deviation in the COP curve—in response to perturbations of a large magnitude (p <0.05), whereas the same participants generated higher stiffness about the ankle—a larger value in CCI—in response to perturbations of a small magnitude (p <0.05). These results indicate that participants use different postural strategies pertaining to circumstances. Further, the moment across the ankle decreased with repetitions of the same perturbation (p <0.05), and CCI tended to remain unchanged even in response to a different perturbation following repetition of the same perturbation (p <0.05). These findings suggest that ankle muscle contraction and co-contraction play different roles in regaining and maintaining postural stability. This study demonstrates that ankle moment and stiffness are not correlated in response to external perturbations.
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Affiliation(s)
- Dongwon Kim
- Department of Biongineering, School of Engineering, University of Maryland, College Park, MD, United States of America
- Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland, Baltimore, MD, United States of America
- * E-mail: (DK); (JMH)
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
- * E-mail: (DK); (JMH)
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Hwang JM, Cheong YS, Kang MG, Chun SM, Min YS, Lee YS, Jung TD. Recommendation of Nasogastric Tube Removal in Acute Stroke Patients Based on Videofluoroscopic Swallow Study. Ann Rehabil Med 2017; 41:9-15. [PMID: 28289630 PMCID: PMC5344831 DOI: 10.5535/arm.2017.41.1.9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 07/21/2016] [Indexed: 01/22/2023] Open
Abstract
Objective To evaluate the safety of nasogastric tube (NGT) removal and change to oral feeding with a food thickener for acute stroke patients in whom a videofluoroscopic swallow study (VFSS) confirmed thin liquid aspiration. Methods We retrospectively examined data of 199 patients with first stroke who were diagnosed with dysphagia from 2011 to 2015. Swallowing function was evaluated using VFSS. Patients included in this study were monitored for 4 weeks to identify the occurrence of aspiration pneumonia. The penetration-aspiration scale (PAS) was used to assess VFSS findings. The patients were divided into thin-liquid aspiration group (group 1, n=104) and no thin-liquid aspiration group (group 2, n=95). Results The feeding method was changed from NGT feeding to oral feeding with food thickener (group 1) and without food thickener (group 2). The PAS scores of thin and thick liquids were 6.46±0.65 and 1.92±0.73, respectively, in group 1 and 2.65±0.74 and 1.53±0.58, respectively, in group 2. Aspiration pneumonia developed in 1.9% of group 1 and 3.2% of group 2 (p=0.578), with no significant difference between the groups. Conclusion We concluded that removing the NGT and changing to oral feeding with a food thickener is a safe food modification for acute stroke patients with thin liquid aspiration. Therefore, we recommend that VFSS should be conducted promptly in acute stroke patients to avoid unnecessary prolonged NGT feeding.
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Affiliation(s)
- Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea
| | - Youn-Soo Cheong
- Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea
| | - Min-Gu Kang
- Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea
| | - Seong Min Chun
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Yu-Sun Min
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Yang-Soo Lee
- Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea
| | - Tae-Du Jung
- Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea.; Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
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Min YS, Chang Y, Park JW, Lee JM, Cha J, Yang JJ, Kim CH, Hwang JM, Yoo JN, Jung TD. Change of Brain Functional Connectivity in Patients With Spinal Cord Injury: Graph Theory Based Approach. Ann Rehabil Med 2015; 39:374-83. [PMID: 26161343 PMCID: PMC4496508 DOI: 10.5535/arm.2015.39.3.374] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 10/10/2014] [Indexed: 11/12/2022] Open
Abstract
Objective To investigate the global functional reorganization of the brain following spinal cord injury with graph theory based approach by creating whole brain functional connectivity networks from resting state-functional magnetic resonance imaging (rs-fMRI), characterizing the reorganization of these networks using graph theoretical metrics and to compare these metrics between patients with spinal cord injury (SCI) and age-matched controls. Methods Twenty patients with incomplete cervical SCI (14 males, 6 females; age, 55±14.1 years) and 20 healthy subjects (10 males, 10 females; age, 52.9±13.6 years) participated in this study. To analyze the characteristics of the whole brain network constructed with functional connectivity using rs-fMRI, graph theoretical measures were calculated including clustering coefficient, characteristic path length, global efficiency and small-worldness. Results Clustering coefficient, global efficiency and small-worldness did not show any difference between controls and SCIs in all density ranges. The normalized characteristic path length to random network was higher in SCI patients than in controls and reached statistical significance at 12%-13% of density (p<0.05, uncorrected). Conclusion The graph theoretical approach in brain functional connectivity might be helpful to reveal the information processing after SCI. These findings imply that patients with SCI can build on preserved competent brain control. Further analyses, such as topological rearrangement and hub region identification, will be needed for better understanding of neuroplasticity in patients with SCI.
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Affiliation(s)
- Yu-Sun Min
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Yongmin Chang
- Department of Molecular Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jang Woo Park
- Department of Medical & Biological Engineering, Kyungpook National University, Daegu, Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Jungho Cha
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Jin-Ju Yang
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Chul-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jong-Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Ji-Na Yoo
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Tae-Du Jung
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
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Kim E, Kim JH, Hwang JM, Choi BS, Jung C. MR imaging of congenital or developmental neuropathic strabismus: common and uncommon findings. AJNR Am J Neuroradiol 2012; 33:2056-61. [PMID: 22595903 DOI: 10.3174/ajnr.a3136] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE High-resolution MR imaging enables direct imaging of the ocular motor nerves. The aim of this study was to assess the various causes of congenital or developmental neuropathic strabismus by using high-resolution MR imaging. MATERIALS AND METHODS High-resolution MR imaging was performed to evaluate the ocular motor nerves (CNIII, CNIV, CNVI) in 247 consecutive patients with suspected congenital or developmental neuropathic strabismus. These MR images, along with those obtained from conventional MR imaging of the brain and the orbit, were evaluated. RESULTS MR imaging abnormalities were found in 112 patients: ocular motor nerve abnormalities in 98 patients (88%), orbital abnormalities in 9 patients (8%), and brain abnormalities in 5 patients (4%). Ocular motor nerve abnormalities were CNIV aplasia (63%), CNVI aplasia or hypoplasia (21%), CNIII aplasia or hypoplasia (3%), and combined CNIII aplasia and CNVI hypoplasia (1%). Orbital abnormalities were EOM hypoplasia (7%), EOM hypertrophy (1%), and fibrotic mass (1%). Brain abnormalities were periventricular leukomalacia (4%) and periventricular heterotopia (1%). CONCLUSIONS Various MR imaging abnormalities were associated with congenital and developmental neuropathic strabismus. The most common abnormality was CNIV aplasia.
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Affiliation(s)
- E Kim
- Departments of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea
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Lee IB, Choi BH, Hwang JM, Kim SS, Park KS. Measurement of ocular torsion using iterative optical flow. Conf Proc IEEE Eng Med Biol Soc 2007; 2004:1471-4. [PMID: 17271973 DOI: 10.1109/iembs.2004.1403453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
This work represents a new method for measuring ocular torsion using optical flow. Feature points are obtained from reference and current image, and the relative optical flows of each point are calculated. The feature points are selected according to the strength of corner on the signature of iris. This method is robust and effective in calculation.
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Affiliation(s)
- I B Lee
- Interdisciplinary Program of Med. & Biol. Eng. Major, Seoul Nat. Univ., South Korea
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Abstract
Several different mitochondrial DNA (mtDNA) sites for mutations of Leber's hereditary optic neuropathy (LHON) have been reported to be present in patients with multiple sclerosis (MS). To further study this association of LHON and MS in the Korean population, we tested 20 MS patients for the presence of mtDNA mutations at nucleotide (nt) 11778 in all 20 patients, and at nt 14484, nt 3460 and nt 15257 in 15, 12 and 12 patients, respectively. However, none of the MS patients exhibited any pathogenic LHON mtDNA mutations. In conclusion, we found no evidence for any association between MS and the LHON mutation in the Korean population.
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Affiliation(s)
- J M Hwang
- Department of Ophthalmology, Seoul Municipal Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea.
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Abstract
Lymphoblastic lymphoma (LBL) frequently affects young adults and usually presents with a mediastinal mass as well as bone marrow involvement. Although the frequency of LBL in the Far East is higher than that of Western countries, no reports regarding treatment of this disease have as yet been reported. We herein report our treatment experience and verify the efficacy of the Stanford/Northern California Oncology Group (NCOG) protocol for this disease and recommend treatment strategies for LBL patients. We retrospectively reviewed the medical records of adult LBL patients treated in our hospital from 1986 to 1996. Twenty-seven patients were diagnosed to have LBL. These patients' ages ranged from 17 to 73 years old with a median of 23. Nineteen patients had an initial stage IV disease. Of the 23 cases in which immunological studies were performed, 20 proved to be of T cell lineage, 1 of B cell type, and the other 2 lacked both T and B markers. Three major chemotherapeutic regimens including prednisone, methotrexate, doxorubicin, cyclophosphamide, etoposide-mechlorethamine, vincristine, procarbazine, prednisone (ProMACE-MOPP), cyclophosphamide, hydroxydaunomycin, vincristine, prednisone (CHOP), and the Stanford/NCOG protocol were used to treat 3, 6, and 15 patients, respectively. Two other patients were treated with two different chemotherapeutic regimens, respectively. One patient was excluded for analysis because of initial treatment by surgery. The complete response (CR) rates with ProMACE-MOPP, CHOP, and the Stanford/NCOG regimens were 0%, 17%, 80% and median overall survival 9, 8.5, and 15 months, respectively. Five patients with stage II-III diseases achieved long-term disease-free survival of 11-36 months with the Stanford/NCOG protocol with a median follow-up of 24 months. Four patients in late stage or relapse received allogeneic bone marrow transplantation (BMT). Two of them obtained long-term disease-free survival. Two other patients in CR were treated with high-dose chemotherapy (HDCT) supported with autologous BMT and peripheral blood stem cell transplantation (PBSCT), respectively. The patient receiving HDCT with autologous PBSCT died of LBL relapse 6 months after transplantation. The other patient undergoing HDCT with autologous BMT died of fulminant hepatitis 5.5 months after transplantation. The median overall survival of all these 26 patients was 12 months. B symptoms and treatment without the Stanford/NCOG protocol were found to have significantly negative impacts on both patients' overall and progression-free survivals. Our results suggest that the Stanford/NCOG protocol may be an effective chemotherapy for adult LBL and may provide long-term remission for patients in an early stage of disease. For those patients with LBL in an advanced stage or in relapse, HDCT with allogeneic or autologous BMT is probably the treatment of choice.
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Affiliation(s)
- Y C Chen
- Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
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Kee C, Sohn S, Hwang JM. Stromelysin gene transfer into cultured human trabecular cells and rat trabecular meshwork in vivo. Invest Ophthalmol Vis Sci 2001; 42:2856-60. [PMID: 11687529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
PURPOSE To determine whether stromelysin gene can be introduced into and expressed in the cultured human trabecular cells as well as in the rat eye in vivo through means of a recombinant replication-deficient adenovirus. METHODS Stromelysin cDNA was obtained by reverse transcription-polymerase chain reaction with mRNA extracted from the cultured human trabecular cells after induction with interleukin 1alpha. Adenovirus vector that contains stromelysin cDNA was constructed by cotransfection of pJM17 and pDeltaA.CMV-str into the 293 cells. The expression of stromelysin in the cultured human trabecular cells was assayed by Western blot and zymography. The expression of stromelysin in the trabecular meshwork of the rat eyes was detected by in situ hybridization and immunohistochemistry. RESULTS The constructed adenovirus vector contained stromelysin cDNA, but no E1 region. Western blot and zymogram revealed that the stromelysin could be expressed and that it possessed enzymatic activity in cultured human trabecular cells. In situ hybridization and immunostaining of the stromelysin showed that the complete form of stromelysin was expressed in the trabecular meshwork, the iris, and the uveoscleral outflow pathway of the rat eye. CONCLUSIONS Stromelysin, a functional gene, can be transferred in vivo into rat eyes and in vitro into cultured human trabecular cells using a replication-deficient adenovirus vector. This shows the possibility of gene therapy in glaucoma.
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Affiliation(s)
- C Kee
- Department of Ophthalmology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea.
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Huang HS, Chiu HF, Hwang JM, Jen YM, Tao CW, Lee KY, Lai YL. Studies on anthracenes. 2. Synthesis and cytotoxic evaluation of 9-acyloxy 1,8-dichloroanthracene derivatives. Chem Pharm Bull (Tokyo) 2001; 49:1346-8. [PMID: 11605668 DOI: 10.1248/cpb.49.1346] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The synthesis and cytotoxic evaluation of 9-acyloxy 1,8-dichloroanthracene derivatives are described. The system selectively reduces the carbonyl group flanked by the peri substituents of the anthracenediones to give the corresponding 1,8-dichloro-9(10H)-anthracenone. Simple acylation of anthracenone occurred with appropriate acyl chlorides in CH2Cl2 with a catalytic amount of pyridine to give the 9-acyloxy-1,8-dichloroanthracene derivatives. Considerable interest has developed in the mechanism of how anthracenones achieve this desirable selectivity. These compounds were evaluated in vitro for their ability to inhibit the growth of human oral epidermoid carcinoma cells (KB cell line), human cervical carcinoma cells of ME 180 (GBM 8401) and Chinese hamster ovary (CHO) cells, respectively, as compared to mitoxantrone. The in vitro cytotoxicity evaluation of 9-acyloxy 1,8-dichloroanthracenes against these above cell lines revealed for most of the compounds a cytotoxic potency lower than that of mitoxantrone. The most active compounds were thus selected for further in vitro biological evaluation and structural modification.
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Affiliation(s)
- H S Huang
- School of Pharmacy, National Defense Medical Center, Taipei, Taiwan, ROC.
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Jen YM, Hsu WL, Chen CY, Hwang JM, Chang LP, Lin YS, Su WF, Chen CM, Liu DW, Chao HL. Different risks of symptomatic brain necrosis in NPC patients treated with different altered fractionated radiotherapy techniques. Int J Radiat Oncol Biol Phys 2001; 51:344-8. [PMID: 11567807 DOI: 10.1016/s0360-3016(01)01631-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To report our observation of excessive temporal lobe necrosis in nasopharyngeal carcinoma (NPC) patients treated with 160 cGy b.i.d. radiotherapy technique. During the same period, patients treated with 120 cGy b.i.d. have not shown a similar tendency. Our experience may be useful for designing unconventional radiotherapy regimens for NPC patients. METHODS AND MATERIALS During the period from October 1991 to January 1998, 81 M0, previously untreated NPC patients completed altered fractionated radiotherapy. Seventy patients were treated with the hyperfractionated technique, and 11 were treated using the accelerated-hyperfractionated scheme. Hyperfractionated radiotherapy was delivered using 120 cGy b.i.d. separated by 6-h intervals throughout the course. A minimum tumor dose of 8000 cGy was the standard dose over an 8-week period. With the accelerated-hyperfractionated scheme, 160 cGy was given twice daily, also with an interval of 6 h. The minimum tumor dose ranged between 6840 and 7640 cGy, with 7 of the 11 patients receiving 7000 cGy. The arrangement of portals was the same for both regimens. The follow-up period for patients alive was from 32 to 102 months with a median of 61 months for the hyperfractionated patients. For the accelerated-hyperfractionated group, it ranged from 67 to 82 months with a median of 72 months. No patient was lost to follow-up. RESULTS At the time of analysis, 49 of the 70 patients in the hyperfractionated group were alive. In the accelerated group, 8 of the 11 patients were alive. The estimated radiation dose to the temporal lobe for the hyperfractionated group was 6000-7440 cGy with a median of 7080 cGy. For the accelerated-hyperfractionated group, the dose range was 4480-6700 cGy with a median of 6400 cGy. Of the 70 patients treated with hyperfractionated radiotherapy, none developed symptomatic brain necrosis, despite the higher total dose to the temporal lobe in general. In contrast, 3 of the 11 (27%) patients irradiated using the accelerated-hyperfractionated regimen suffered from temporal lobe necrosis at 16, 19, and 40 months after completion of radiotherapy. CONCLUSION An excessive incidence of temporal lobe necrosis was noted when an accelerated-hyperfractionated regimen with 160 cGy b.i.d. was used in NPC patients with a median brain dose of 6400 cGy. There has been no such event in patients treated using a hyperfractionated regimen with 120 cGy and a median brain dose of 7000 cGy. The real causes of this discrepancy are not known. However, a high sensitivity of the human brain to a change in fraction size may play a role.
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Affiliation(s)
- Y M Jen
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
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Huang HS, Lin PY, Hwang JM, Tao CW, Hsu HC, Lai YL. Studies on anthracenes. 3. Synthesis, lipid peroxidation and cytotoxic evaluation of 10-substituted 1,5-dichloro-9(10H)-anthracenone derivatives. Chem Pharm Bull (Tokyo) 2001; 49:1288-91. [PMID: 11605655 DOI: 10.1248/cpb.49.1288] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The synthesis of a series of 1,5-dichloro-9(10H)-anthracenones bearing O-linked and N-linked substituents in the 10-position are described. Previous studies have shown that 9-acyloxy 1,5-dichloroanthracenes and 9-acyloxy 1,8-dichloroanthracenes displayed a potential cytotoxic effect. These results have encouraged us in further investigation of potential anthracenone derivatives. Therefore, a series of 10-substituted 1,8-dichloro-9(10H)-anthracenone derivatives were synthesized. These compounds were evaluated for their ability to inhibit the growth of human oral epidermoid carcinoma cells (KB cell line), human cervical carcinoma cells of ME 180 (GBM 8401) and Chinese hamster ovary (CHO) cells, respectively. Compounds 3c and 4c of this series compare favorably in the KB cellular assay with mitoxantrone. Compound 4c showed combined inhibitory action against KB, GBM and CHO cell growth, respectively. In addition, redox property of the compounds for the inhibition of lipid peroxidation in model membranes was determined. Compounds 4b and 4d exhibited stronger antioxidant activity than ascorbic acid, (+)-alpha-tocopherol and mitoxantrone, respectively.
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Affiliation(s)
- H S Huang
- School of Pharmacy, National Defense Medical Center, Taipei Medical University, Taiwan, ROC.
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Choi MY, Lee KM, Hwang JM, Choi DG, Lee DS, Park KH, Yu YS. Comparison between anisometropic and strabismic amblyopia using functional magnetic resonance imaging. Br J Ophthalmol 2001; 85:1052-6. [PMID: 11520755 PMCID: PMC1724107 DOI: 10.1136/bjo.85.9.1052] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To assess calcarine activation with functional magnetic resonance imaging (fMRI) in patients with anisometropic and strabismic amblyopia. METHODS 14 amblyopes (eight anisometropic and six strabismic) were studied with fMRI using stimuli of checkerboards of various checker sizes and temporal frequencies. While T2* weighted MRI were obtained every 3 seconds for 6 minutes, patients viewed the stimuli monocularly with either the amblyopic or sound eye. RESULTS Amblyopic eyes showed reduced calcarine activation compared with contralateral sound eyes in fMRI in all subjects. The calcarine activation from amblyopic eyes in anisometropic amblyopes was more suppressed at higher spatial frequencies, while that from amblyopic eyes in strabismic amblyopes was more suppressed at lower spatial frequencies. CONCLUSION These results suggest that fMRI is a useful tool for the study of amblyopia in humans. The calcarine activation via amblyopic eyes because of anisometropia or strabismus has different temporospatial characteristics, which suggests differences in the neurophysiological mechanisms between two types of amblyopia.
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Affiliation(s)
- M Y Choi
- Department of Ophthalmology, College of Medicine, Chungbuk National University, Korea
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Huang HS, Hwang JM, Jen YM, Lin JJ, Lee KY, Shi CH, Hsu HC. Studies on anthracenes. 1. Human telomerase inhibition and lipid peroxidation of 9-acyloxy 1,5-dichloroanthracene derivatives. Chem Pharm Bull (Tokyo) 2001; 49:969-73. [PMID: 11515587 DOI: 10.1248/cpb.49.969] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The synthetically useful approaches to 9-acyloxy 1,5-dichloroanthracene derivatives are reported. The system selectively reduces the carbonyl group flanked by the peri substituents of the anthracenediones to give the corresponding 1,5-dichloro-9(10H)-anthracenone. Simple regioselective acylation of anthracenone is applied with appropriate acyl chlorides in CH2Cl2 with catalytic amount of pyridine to give the novel 9-acyloxy 1,5-dichloroanthracene derivatives. Considerable interest has developed in the mechanism of how anthracenone achieves this desirable selectivity. In an attempt to understand the mechanism of this reaction, solid-state structures of anthracene derivatives have been obtained. In addition, the inhibition of lipid peroxidation in model membranes was determined as was their ability to inhibit the telomere-addition function of the human telomerase enzyme together with their inhibition of the Taq polymerase enzyme. In contrast to (+)-alpha-tocopherol, 3b, 3c, 3d, 3g, and 3i do not enhance lipid peroxidation in model membranes. Implications for 9-acyloxy 1,5-dichloroanthracene analogues as potential anticancer agents are discussed.
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Affiliation(s)
- H S Huang
- School of Pharmacy, National Defense Medical Center, Taipei, Taiwan, ROC.
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Lee KM, Lee SH, Kim NY, Kim CY, Sohn JW, Choi MY, Gyu Choi D, Hwang JM, Ho Park K, Lee DS, Suk Yu Y, Hyun Chang K. Binocularity and spatial frequency dependence of calcarine activation in two types of amblyopia. Neurosci Res 2001; 40:147-53. [PMID: 11377753 DOI: 10.1016/s0168-0102(01)00220-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE AND BACKGROUND Strabismus and anisometropia early in life frequently causes monocular amblyopia. Activation of the visual cortex is compared between the two types of amblyopia to elucidate differences in the pathogenetic mechanism of the disease. METHODS Using an EPI gradient echo sequence in 1.5T MRI, calcarine activation by monocular viewing of checkerboard patterns with reversal was examined in terms of binocularity of the activation and dependence on the spatial frequency of the stimuli. RESULTS First, the proportion of voxels activated by both normal and amblyopic eye monocular stimulations is lower in the strabismic group than in the anisometropic group. Second, the activation by higher-spatial-frequency stimuli is reduced in the anisometropic group, but not in the strabismic group. CONCLUSIONS These findings from the human visual cortex are consistent with the view proposed based on animal research that the loss of binocular interaction and the undersampling of high-spatial-frequency components of visual stimuli are each one of the underlying changes in strabismic and anisometropic amblyopia, respectively.
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Affiliation(s)
- K M Lee
- Department of Neurology, Seoul National University, 110-744, Seoul, South Korea.
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Affiliation(s)
- K H Lim
- Department of Ophthalmology, College of Medicine, Ewha Women's University, Seoul, Korea
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Hwang JM, Min BM, Park SC, Oh SY, Sung NK. A randomized comparison of prism adaptation and augmented surgery in the surgical management of esotropia associated with hypermetropia: one-year surgical outcomes. J AAPOS 2001; 5:31-4. [PMID: 11182670 DOI: 10.1067/mpa.2001.111782] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare motor and sensory 1-year surgical outcomes in patients with hypermetropic esotropia, managed with either augmented surgery based on the average of the near deviation with and without correction or preoperative prism adaptation. METHODS Forty-three patients with hypermetropic esotropia without distance-near disparity entered a randomized prospective evaluation of augmented surgery (group A, 27 patients) versus prism adaptation (group P, 16 patients). The formula for augmenting the amount of the rectus muscle recession was based on the average of the near deviation with and without correction in group A and the prism-adapted angle of deviation in group P. During prism adaptation, 9 of 16 patients in group P responded to prism. Motor and sensory outcomes of the Worth 4-dot test at 6 and 0.33 m and the Titmus stereotest were evaluated 1, 3, 6, and 12 months after surgery. RESULTS Postoperative deviations of 8 PD or less at distance were achieved in 24 of 27 patients (89%) of group A and in 7 of the remaining 8 patients (88%) of prism responders and in all 7 prism nonresponders (100%) in group P. No significant difference existed between groups A and P, as well as between the prism responders and prism nonresponders in group P in terms of near and distance deviation 1 year after surgery. The sensory outcomes improved over time in group A and prism responders. CONCLUSION There were no significant differences in the surgical outcomes between each group. However, the small sample size may limit the power to detect any statistically significant differences.
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Affiliation(s)
- J M Hwang
- Department of Ophthalmology, Seoul Municipal Boramae Hospital, Seoul National University, Seoul, Korea
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Abstract
PURPOSE To report the spontaneous resolution of infantile esotropia in 3 patients. METHODS The clinical histories and the results of ophthalmologic examinations in 3 patients with infantile esotropia were reviewed and analyzed with reference to the literature. RESULTS All 3 patients with infantile esotropia were diagnosed with 25 to 30 PD of esotropia before the age of 6 months. All of them had insignificant refractive errors. Against medical advice, they were not brought in for follow-up examinations. At the age of 34 months to 59 months, the esotropia of the patients had changed into exophoria, esophoria less than 4 PD, or orthophoria. All patients eventually showed dissociated vertical deviation and overaction of the inferior oblique muscles. Of the 2 cooperative patients, 1 consistently identified Titmus stereograms with 3000 seconds of arc and fused Worth 4 dots at near and at distance. The other patient could not identify stereo targets and suppressed one eye on Worth 4 testing at distance, though she showed no suppression at near. CONCLUSION In these cases, infantile esotropia with a relatively small angle may spontaneously resolve without any treatment. However, all these patients showed poor stereoacuity, dissociated vertical deviation, and overaction of the inferior oblique muscles.
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Affiliation(s)
- M A Shon
- Department of Ophthalmology, Chunchon Sacred Heart Hospital, Hallym University, Chunchon, Korea
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Abstract
PURPOSE To report the association of Marcus Gunn jaw-winking phenomenon and pseudo inferior oblique overaction. METHODS Case report. RESULTS A 21-year-old woman presented with right eyelid elevation on the chewing movement since infancy. Examination showed that both Marcus Gunn jaw-winking phenomenon and pseudo inferior oblique overaction coexist in this patient. CONCLUSION The association of Marcus Gunn jaw winking and pseudo inferior oblique overaction in one patient is reported. This coexistence in our case may provide some support to the existing concept that both phenomena are caused by an ocular aberrant innervation.
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Affiliation(s)
- J M Hwang
- Department of Ophthalmology, Seoul Municipal Boramae Hospital, College of Medicine, Seoul National University, Seoul, South Korea
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Abstract
Visual loss with optic atrophy is common in osteopetrosis. The efficacy of optic nerve decompression in patients with osteopetrosis is still controversial. The purpose of this study is to report that visual deterioration in osteopetrosis can be completely reversed by early optic nerve decompression. An 8-year-old female patient with osteopetrosis was found to have reduced visual acuity on routine ophthalmologic examination. Extensive optic nerve decompression was performed. It not only included unroofing the optic canal, but also drilling away bone on both sidewalls of the optic nerve. Both optic nerves were decompressed during the same surgical procedure. Progressive loss of vision associated with osteopetrosis can be prevented by optic nerve decompression in the early stage of visual deterioration. When managing patients with osteopetrosis, the importance of careful and regular assessment of visual function should be stressed.
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Affiliation(s)
- J M Hwang
- Department of Ophthalmology, Seoul Municipal Boramae Hospital, Seoul National University, Seoul, Korea
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Lin WL, Wang CJ, Tsai YY, Liu CL, Hwang JM, Tseng TH. Inhibitory effect of esculetin on oxidative damage induced by t-butyl hydroperoxide in rat liver. Arch Toxicol 2000; 74:467-72. [PMID: 11097384 DOI: 10.1007/s002040000148] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Increasing evidence regarding free radical-generating agents and inflammatory processes suggests that accumulation of reactive oxygen species can cause hepatotoxicity. A short-chain analog of lipid hydroperoxide, t-butyl hydroperoxide (t-BHP), can be metabolized to free radical intermediates by cytochrome P-450 in hepatocytes, which in turn can initiate lipid peroxidation, affect cell integrity and result in cell injury. In this study, we used t-BHP to induce hepatotoxicity in vitro and in vivo and determined the antioxidative bioactivity of esculetin, a coumarin compound. Our investigations showed that pretreatment with esculetin (5-20 microg/ml) significantly decreased the leakage of lactate dehydrogenase (LDH) and alanine transaminase (ALT), and also decreased the formation of malondialdehyde (MDA) in primary cultured rat hepatocytes induced by a 30-min treatment with t-BHP. An in vivo study in rats showed that pretreatment with esculetin (i.p.) at concentrations of 0.5 and 5 mg/kg for 5 days before a single i.p. dose of t-BHP (0.1 mmol/kg) significantly lowered the serum levels of the hepatic enzyme markers (ALT and AST) and reduced oxidative stress in the liver. Histopathological evaluation of the rat livers revealed that esculetin reduced the incidence of liver lesions induced by t-BHP, including hepatocyte swelling, leukocyte infiltration, and necrosis. Based on the results described above, we speculate that esculetin may play a chemopreventive role via reducing oxidative stress in living systems.
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Affiliation(s)
- W L Lin
- Department of Pathology, Chung Shan Medical and Dental College, Taichung, Taiwan
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Abstract
Leber's hereditary optic neuropathy (LHON) is caused by a point mutation in the mitochondrial deoxynucleic acid (mtDNA) and accounts for 30% of bilateral optic atrophy of unknown etiology. The authors found a Korean family with mtDNA mutations in the nucleotide positions (np) 11778 and np 4216. This is the first report confirming a secondary mtDNA np 4216 mutation in Koreans, as well as the first report of a Korean family harboring both primary and the secondary mutations that the authors are aware of.
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Affiliation(s)
- J M Hwang
- Department of Ophthalmology, Seoul Municipal Boramae Hospital, College of Medicine Seoul National University, Korea
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Abstract
PURPOSE To determine a more reliable method for performing delayed suture adjustment to prevent the formation of postoperative adhesions and delay the time of adjustment. METHODS Thirty-two rabbit eyes were divided into three groups. After recession of the superior rectus muscle, 5-fluorouracil (5-FU) was administered beneath and over the superior rectus muscle in group 5-FU (12 eyes); polytetrafluoroethylene (PTFE) and 5-FU were administered in group P-f (10 eyes); and PTFE, 5-FU, and Viscoat (chondroitin sulfate, sodium hyaluronate, Alcon Laboratories Inc, Fort Worth, Tex) were administered in group P-fv (10 eyes). Delayed adjustment was performed once on each superior rectus muscle at 1, 2, and 3 weeks postoperatively in group 5-FU and at 2 and 4 weeks postoperatively in groups P-f and P-fv. The length and force for the adjustment and the degree of adhesions were recorded. RESULTS The use of fluorouracil allowed adjustment to be delayed up to 1 week after surgery in three of four eyes. The combined use of PTFE and 5-FU or addition of Viscoat allowed adjustment to be delayed for up to 4 weeks after surgery in four of five eyes. CONCLUSION The combined use of PTFE, 5-FU and Viscoat is useful for delaying suture adjustment in rabbit eyes.
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Affiliation(s)
- J M Hwang
- Department of Ophthalmology, Seoul Municipal Boramae Hospital, and the College of Medicine, Seoul National University, Korea
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Hwang JM, Chang DJ, Kim US, Lee YS, Park YS, Kaang BK, Cho NJ. Cloning and functional characterization of a Caenorhabditis elegans muscarinic acetylcholine receptor. Recept Channels 2000; 6:415-24. [PMID: 10635059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
A cDNA clone encoding a muscarinic acetylcholine receptor (mAChR) has been isolated from the nematode Caenorhabditis elegans. The nematode mAChR, consisted of 585 amino acids, displays a high degree of amino acid sequence homology to other invertebrate and vertebrate mAChRs. Excluding a highly variable middle portion of the third intracellular loop, the C. elegans mAChR shares about 51% amino acid sequence identity with a Drosophila mAChR and 42-44% identity with human m1-m5 mAChR subtypes. Comparison of the cDNA sequence with the corresponding genomic sequence reveals that the C. elegans mAChR gene contains ten introns, eight of them in the coding region. Pharmacological profiles of the C. elegans mAChR expressed in Chinese hamster ovary (CHO) cells were shown to be similar to those of mammalian counterparts, indicating that ligand binding domains of the receptor have been conserved during evolution. When this cloned receptor was expressed in Xenopus oocytes, acetylcholine evoked a transient Cl- current. Furthermore, activation of the receptor with oxotremorine, acetylcholine or carbachol resulted in the stimulation of phosphatidylinositol metabolism in CHO cells, suggesting that the receptor is coupled to phospholipase C activation.
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Affiliation(s)
- J M Hwang
- Department of Biochemistry, College of Natural Sciences, Chungbuk National University, Cheongju, South Korea
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50
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Lee MJ, Wang CJ, Tsai YY, Hwang JM, Lin WL, Tseng TH, Chu CY. Inhibitory effect of 12-O-tetradecanoylphorbol-13-acetate-caused tumor promotion in benzo[a]pyrene-initiated CD-1 mouse skin by baicalein. Nutr Cancer 1999; 34:185-91. [PMID: 10578486 DOI: 10.1207/s15327914nc3402_9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The effects of topical application of baicalein on 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced promotion of skin tumors, hyperplasia, ornithine decarboxylase activity, and inflammation were evaluated in female CD-1 mice. Topical application of baicalein (0.08, 0.16, or 0.2 mumol) with TPA (5 nmol) twice weekly for 24 weeks to mice previously initiated with benzo[a]pyrene inhibited the number of TPA-induced tumors per mouse significantly. Preapplication of the same amount of baicalein also afforded significant protection against TPA-induced hyperplasia in the ear skin. Topical application of baicalein inhibited tumor promoter-caused induction of epidermal ornithine decarboxylase activity by TPA (5 nmol). The topical application of baicalein (0.008, 0.016, or 0.02 mumol) inhibited TPA-induced edema of mouse ears by 88%, 96%, or 97%, respectively. Pretreatment of mouse skin with various amounts of baicalein caused inhibition of H2O2 and myeloperoxidase formation by TPA. These results indicate that baicalein can be a potential cancer-chemopreventive agent against tumor promotion.
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Affiliation(s)
- M J Lee
- Institute of Biochemistry, Chung Shan Medical and Dental College Hospital, Taichung, Taiwan
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