Publications by authors named "Eunkyung Kim"

89 Publications

Description and Evaluation of the AACN Synergy Model for Patient Care Employing the Critique Frameworks of Chinn and Kramer (2011) and Fawcett and DeSanto-Madeya (2013).

ANS Adv Nurs Sci 2021 Jul 13. Epub 2021 Jul 13.

College of Nursing, Yonsei University, Seoul, Republic of Korea.

This study describes and evaluates the AACN Synergy Model for Patient Care that aligns nurses' competencies with the needs of patients and their families, developed by the American Association of Critical-Care Nurses. The description focuses on objectively explaining the theory, while the evaluation is based on established standards to determine its viability for application in nursing practice. This study applies Chinn and Kramer's (2011) theoretical description method and Fawcett and DeSanto-Madeya's (2013) theory analysis method to evaluate the AACN Synergy Model for Patient Care. Focusing on the patient-nurse relationship, the theory is appropriate for various nursing applications.
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http://dx.doi.org/10.1097/ANS.0000000000000367DOI Listing
July 2021

Barriers and Facilitators of Nurses' and Physicians' Willingness to Work during a Respiratory Disease Outbreak: A Mixed-Methods Systematic Review.

Int J Environ Res Public Health 2021 06 25;18(13). Epub 2021 Jun 25.

College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.

This review was undertaken to identify the perceived barriers and facilitators of nurses' and physicians' willingness to work during a respiratory disease outbreak. This mixed-methods systematic review involved the extraction of data from the electronic databases PubMed, Web of Science, CINAHL, and PsycINFO and from a manual search of articles published between 2003 and April 2021. The quality of the included studies was assessed using a mixed-method appraisal tool. A total of 29 studies were eligible for inclusion: 21 quantitative and 8 qualitative. Using the Integrated Behavioral Model, perceived barriers and facilitators were identified under seven categories: demographics, attitude, perceived norm, personal agency, knowledge and skills to perform the behavior, environmental constraints, and habit. The results of this study broaden the understanding of various factors that affect nurses' and physicians' willingness to work during a respiratory disease outbreak. These findings will facilitate the modification of current pandemic workplace staffing strategies and practices and will inform preparedness planning for similar situations in the future.
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http://dx.doi.org/10.3390/ijerph18136841DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8296986PMC
June 2021

Brain activation in response to visual sexual stimuli in male patients with right middle cerebral artery infarction: The first case-control functional magnetic resonance imaging study.

Medicine (Baltimore) 2021 May;100(21):e25823

Department of Rehabilitation Medicine, Hanyang University Guri Hospital, Gyeonggi-do.

Abstract: Sexual dysfunction is a common problem after cerebral infarction; however, little is known about sexual arousal in poststroke patients. Thus, this study aimed to investigate brain activation in response to visual sexual stimuli in patients with right middle cerebral artery (MCA) territory infarction using functional magnetic resonance imaging (fMRI). Using fMRI in 20 participants (11 right MCA infarction patients and 9 age-matched healthy controls), we assessed brain activation elicited by visual sexual stimuli (erotic images) and visual nonsexual stimuli (landscape images). In right MCA infarction patients, the left dorsolateral prefrontal cortex and the left frontal subgyral area were more strongly activated by visual sexual stimuli than by nonvisual sexual stimuli. Brain areas that were more activated by visual sexual stimuli in right MCA infarction patients than in controls included the right parahippocampal gyrus and the bilateral frontal subgyral area. These fMRI results suggest that brain activation patterns in response to visual sexual stimuli might be influenced by right MCA infarction. Further research is needed to explore the association between sexual dysfunction and brain activation in poststroke patients.
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http://dx.doi.org/10.1097/MD.0000000000025823DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8154462PMC
May 2021

Physicochemical characteristics of Ethiopian cv. Heirloom coffee extracts with various roasting conditions.

Food Sci Biotechnol 2021 Feb 6;30(2):235-244. Epub 2021 Feb 6.

Research Center for Industrialization of Natural Nutraceuticals, Dankook University, Cheonan, Chungnam 31116 Republic of Korea.

This study aimed to investigate the physicochemical characteristics of Ethiopian cv. Heirloom coffee extracts with various roasting conditions. Green coffee beans were roasted at four different conditions (Light-medium, Medium, Moderately dark, and Very dark) and used to extract espresso and drip coffee. Moisture content in coffee beans was decreased as the roasting degree increased. The contents of crude fat and ash were lower in the Light-medium roasted coffee beans than in green coffee beans but increased as the roasting degree increased. The values of lightness (L), redness (a), yellowness (b), and browning index of coffee extracts were decreased as the roasting degree increased. Total dissolved solids in espresso coffee were increased with increasing roasting degree but decreased in drip coffee. In both the extracts, the contents of reducing sugar, titratable acidity, organic acids, and chlorogenic acid were decreased, but that of caffeine was increased with the roasting degree increased.

Supplementary Information: The online version contains supplementary material available at 10.1007/s10068-020-00865-w.
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http://dx.doi.org/10.1007/s10068-020-00865-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914306PMC
February 2021

Physicochemical characteristics of Ethiopian cv. Heirloom coffee extracts with various roasting conditions.

Food Sci Biotechnol 2021 Feb 6;30(2):235-244. Epub 2021 Feb 6.

Research Center for Industrialization of Natural Nutraceuticals, Dankook University, Cheonan, Chungnam 31116 Republic of Korea.

This study aimed to investigate the physicochemical characteristics of Ethiopian cv. Heirloom coffee extracts with various roasting conditions. Green coffee beans were roasted at four different conditions (Light-medium, Medium, Moderately dark, and Very dark) and used to extract espresso and drip coffee. Moisture content in coffee beans was decreased as the roasting degree increased. The contents of crude fat and ash were lower in the Light-medium roasted coffee beans than in green coffee beans but increased as the roasting degree increased. The values of lightness (L), redness (a), yellowness (b), and browning index of coffee extracts were decreased as the roasting degree increased. Total dissolved solids in espresso coffee were increased with increasing roasting degree but decreased in drip coffee. In both the extracts, the contents of reducing sugar, titratable acidity, organic acids, and chlorogenic acid were decreased, but that of caffeine was increased with the roasting degree increased.

Supplementary Information: The online version contains supplementary material available at 10.1007/s10068-020-00865-w.
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http://dx.doi.org/10.1007/s10068-020-00865-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914306PMC
February 2021

Diagnostic Models for Screening of Periodontitis with Inflammatory Mediators and Microbial Profiles in Saliva.

Diagnostics (Basel) 2020 Oct 14;10(10). Epub 2020 Oct 14.

R&D Center, Sugentech, Inc., Daejeon 34025, Korea.

This study aims to investigate and assess salivary biomarkers and microbial profiles as a means of diagnosing periodontitis. A total of 121 subjects were included: 28 periodontally healthy subjects, 24 with Stage I periodontitis, 24 with Stage II, 23 with Stage III, and 22 with Stage IV. Salivary proteins (including active matrix metalloproteinase-8 (MMP-8), pro-MMP-8, total MMP-8, C-reactive protein, secretory immunoglobulin A) and planktonic bacteria (including , , , , , , , , , , , , , , and ) were measured from salivary samples. The performance of the diagnostic models was assessed by receiver operating characteristics (ROCs) and area under the ROC curve (AUC) analysis. The diagnostic models were constructed based on the subjects' proteins and/or microbial profiles, resulting in two potential diagnosis models that achieved better diagnostic powers, with an AUC value > 0.750 for the diagnosis of Stages II, III, and IV periodontitis (Model PA-I; AUC: 0.796, sensitivity: 0.754, specificity: 0.712) and for the diagnosis of Stages III and IV periodontitis (Model PA-II; AUC: 0.796, sensitivity: 0.756, specificity: 0.868). This study can contribute to screening for periodontitis based on salivary biomarkers.
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http://dx.doi.org/10.3390/diagnostics10100820DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7602207PMC
October 2020

Reduced Brainstem Volume After Mild Traumatic Brain Injury.

Am J Phys Med Rehabil 2021 05;100(5):473-482

From the Department of Rehabilitation Medicine (EK, HGS, HHL, SHL, SJY, M-GK, B-MO), Biomedical Research Institute (EK), Department of Radiology (SHC, R-EY), and Department of Neurosurgery (W-SC), Seoul National University Hospital, Seoul, Korea; Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea (HHL); Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (SHL); Department of Radiology (SHC, R-EY), Department of Rehabilitation Medicine (B-MO), and Neuroscience Research Institute (B-MO), Seoul National University College of Medicine, Seoul, Korea; Institute on Aging, Seoul National University, Seoul, Korea (B-MO); and National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea (B-MO).

Objective: The aims of this study were to investigate changes in regional brain volume after concussion (mild traumatic brain injury) and to examine the relationship between change in brain volume and cognitive deficits.

Design: Twenty-eight patients with mild traumatic brain injury and 27 age-matched controls were included in this study. Magnetic resonance imaging (3 T) data were obtained from the participants. Structural brain volume changes were examined using tensor-based morphometry, which identifies regional structural differences in the whole brain, including cerebrospinal fluid, gray matter, and white matter. Volume contraction and expansion were compared between groups using a two-sample t test. The association between time post-injury or neurocognitive function and volumetric changes was examined using regression analysis.

Results: Individuals with mild traumatic brain injury exhibited volume reduction in the brainstem, including the pontine reticular formation. Regional cerebral volume changes were not associated with time post-injury but were significantly associated with neurocognitive function, especially with executive card sorting test, forward digit span test, and performance on verbal learning test. The greater regional cerebral volume was associated with better cognitive performance after mild traumatic brain injury.

Conclusion: Decreased brainstem volume may indicate its vulnerability to traumatic injury, and cerebral volume in specific regions was positively associated with patients' cognitive function after injury.
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http://dx.doi.org/10.1097/PHM.0000000000001580DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8032213PMC
May 2021

Reorganized Brain White Matter in Early- and Late-Onset Deafness With Diffusion Tensor Imaging.

Ear Hear 2020 08 21;42(1):223-234. Epub 2020 Aug 21.

Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea.

Objectives: Individuals with early- and late-onset deafness showed different functional and morphological brain changes, but white matter alterations in both deaf groups still need to be elucidated. This study aimed to investigate changes in white matter integrity and white matter anatomical connectivity in both early- and late-onset deaf groups compared with hearing group.

Design: Diffusion tensor imaging data from 7 early-onset deaf (50.7 ± 6.5 years), 11 late-onset deaf (50.9 ± 12.3 years), and 9 hearing adults (48.9 ± 9.5 years) were preprocessed using FSL software. To find changes in white matter integrity, tract-based spatial statistics was used, which implemented on FSL software. Fractional anisotropy (FA), axial diffusivity (AD) and radial diffusivity (RD) were calculated and compared among the groups with age as a nuisance variable. To find out the effect of onset age or duration of deafness to the white matter integrity, onset-age or duration of deafness was treated as a variable of interest in the general linear model implemented on tract-based spatial statistics. White matter connectivity was constructed by a deterministic tractography and compared among the groups.

Results: In comparison to the hearing group, the early-onset deaf group did not show any significant changes but the late-onset deaf group showed decreased FA and increased RD in the several white matter areas. AD in the late-onset deaf group was not significantly different compared with the hearing group. The regions included the corpus callosum, posterior and superior corona radiata, internal capsule, posterior thalamic radiation, superior longitudinal fasciculus, and tapetum of the right hemisphere. Increased RD was also additionally observed in the right external capsule, fornix, and cerebral peduncle. The onset age or duration of deafness was not significantly correlated with the white matter integrity in the early-onset deaf group. In contrast, the onset age showed a significantly positive correlation with the RD, and a negative correlation with the FA, in the late-onset deaf group. The correlated white matter areas were also similar to the findings of comparison with the hearing group. In comparison to the hearing group, the early-onset deaf group did not show altered white matter connectivity, while the late-onset deaf group showed decreased white matter connectivity in between the right lingual and hippocampal areas.

Conclusions: The present results suggest that late-onset deaf adults showed decreased FA and increased RD, and early-onset deaf adults showed no difference compared with the hearing group. In the late-onset deaf adults, onset-age showed a significantly positive correlation with RD and negative correlation with FA. Duration of deafness was not significantly correlated with the changes. Increased RD indicating demyelination occurred in the brain, and the changes were not limited to the auditory cortex but expanded to almost whole brain areas, suggesting significant effect of auditory deprivation on the brain later in life. The altered white matter connectivity in between the right limbic-occipital areas observed in the late-onset deaf group might be caused by altered language functions after auditory deprivation. Future studies are necessary incorporating functional and anatomical aspects of the brain changes in deaf group.
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http://dx.doi.org/10.1097/AUD.0000000000000917DOI Listing
August 2020

Blood-Brain Barrier Disruption in Mild Traumatic Brain Injury Patients with Post-Concussion Syndrome: Evaluation with Region-Based Quantification of Dynamic Contrast-Enhanced MR Imaging Parameters Using Automatic Whole-Brain Segmentation.

Korean J Radiol 2021 01 11;22(1):118-130. Epub 2020 Aug 11.

Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Objective: This study aimed to investigate the blood-brain barrier (BBB) disruption in mild traumatic brain injury (mTBI) patients with post-concussion syndrome (PCS) using dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging and automatic whole brain segmentation.

Materials And Methods: Forty-two consecutive mTBI patients with PCS who had undergone post-traumatic MR imaging, including DCE MR imaging, between October 2016 and April 2018, and 29 controls with DCE MR imaging were included in this retrospective study. After performing three-dimensional T1-based brain segmentation with FreeSurfer software (Laboratory for Computational Neuroimaging), the mean K and v from DCE MR imaging (derived using the Patlak model and extended Tofts and Kermode model) were analyzed in the bilateral cerebral/cerebellar cortex, bilateral cerebral/cerebellar white matter (WM), and brainstem. K values of the mTBI patients and controls were calculated using both models to identify the model that better reflected the increased permeability owing to mTBI (tendency toward higher K values in mTBI patients than in controls). The Mann-Whitney U test and Spearman rank correlation test were performed to compare the mean K and v between the two groups and correlate K and v with neuropsychological tests for mTBI patients.

Results: Increased permeability owing to mTBI was observed in the Patlak model but not in the extended Tofts and Kermode model. In the Patlak model, the mean K in the bilateral cerebral cortex was significantly higher in mTBI patients than in controls ( = 0.042). The mean v values in the bilateral cerebellar WM and brainstem were significantly lower in mTBI patients than in controls ( = 0.009 and = 0.011, respectively). The mean K of the bilateral cerebral cortex was significantly higher in patients with atypical performance in the auditory continuous performance test (commission errors) than in average or good performers ( = 0.041).

Conclusion: BBB disruption, as reflected by the increased K and decreased v values from the Patlak model, was observed throughout the bilateral cerebral cortex, bilateral cerebellar WM, and brainstem in mTBI patients with PCS.
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http://dx.doi.org/10.3348/kjr.2020.0016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7772380PMC
January 2021

Correction to: Effects of robot-assisted gait training in patients with Parkinson's disease: study protocol for a randomized controlled trial.

Trials 2020 05 27;21(1):438. Epub 2020 May 27.

Department of Rehabilitation Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, South Korea.

An amendment to this paper has been published and can be accessed via the original article.
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http://dx.doi.org/10.1186/s13063-020-04437-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254688PMC
May 2020

Target-oriented motor imagery for grasping action: different characteristics of brain activation between kinesthetic and visual imagery.

Sci Rep 2019 09 4;9(1):12770. Epub 2019 Sep 4.

Department of Rehabilitation Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.

Motor imagery (MI) for target-oriented movements, which is a basis for functional activities of daily living, can be more appropriate than non-target-oriented MI as tasks to promote motor recovery or brain-computer interface (BCI) applications. This study aimed to explore different characteristics of brain activation among target-oriented kinesthetic imagery (KI) and visual imagery (VI) in the first-person (VI-1) and third-person (VI-3) perspectives. Eighteen healthy volunteers were evaluated for MI ability, trained for the three types of target-oriented MIs, and scanned using 3 T functional magnetic resonance imaging (fMRI) under MI and perceptual control conditions, presented in a block design. Post-experimental questionnaires were administered after fMRI. Common brain regions activated during the three types of MI were the left premotor area and inferior parietal lobule, irrespective of the MI modalities or perspectives. Contrast analyses showed significantly increased brain activation only in the contrast of KI versus VI-1 and KI versus VI-3 for considerably extensive brain regions, including the supplementary motor area and insula. Neural activity in the orbitofrontal cortex and cerebellum during VI-1 and KI was significantly correlated with MI ability measured by mental chronometry and a self-reported questionnaire, respectively. These results can provide a basis in developing MI-based protocols for neurorehabilitation to improve motor recovery and BCI training in severely paralyzed individuals.
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http://dx.doi.org/10.1038/s41598-019-49254-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726765PMC
September 2019

Altered White Matter Integrity after Mild to Moderate Traumatic Brain Injury.

J Clin Med 2019 Aug 27;8(9). Epub 2019 Aug 27.

Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Korea.

(1) Background: White matter changes among individuals with mild-to-moderate traumatic brain injury (TBI) may be sensitive imaging markers reflecting functional impairment, particularly in the context of post-concussion syndrome. The objective of this study was to examine the altered white matter integrity in mild-to-moderate TBI patients compared with age-matched normal controls. (2) Methods: Diffusion tensor imaging data from 15 individuals with TBI and 15 control subjects were retrospectively obtained. We investigated and compared white matter integrity in both groups, with regard to fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) and examined the relationship with cognitive dysfunction and impaired balance in patients. (3) Results: In comparison with controls, the TBI patients had significantly decreased FA as well as increased RD, in the right corticospinal tract. Decreased RD was observed in the left cerebellar area near the middle cerebellar peduncle. Decreased AD was observed in the left inferior cerebellar peduncle, showing positive correlation with poor balance control. We observed decreased FA and increased AD in the left superior longitudinal fasciculus showing positive and negative correlation, respectively, with cognitive function in the TBI group. (4) Conclusions: Altered white matter integrity in mild-to-moderate TBI cases may be indicative of cognitive dysfunction and impaired balance.
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http://dx.doi.org/10.3390/jcm8091318DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780936PMC
August 2019

A Longitudinal Investigation of Empathic Exchanges in Online Cancer Support Groups: Message Reception and Expression Effects on Patients' Psychosocial Health Outcomes.

J Health Commun 2019 25;24(6):615-623. Epub 2019 Jul 25.

Center for Health Enhancement Systems Studies, University of Wisconsin-Madison , Madison , WI , USA.

Recent studies have devoted attention to the effects of both expression and reception in communication process. However, there remain both theoretical and methodological complexities concerning and message expression and reception play significant but different roles in explaining various psychosocial health outcomes. Relying on theoretical insights from the social support literature and methodological innovations offered by computational social science, this study aims to examine the effects of empathic exchanges on cancer patient's short- and long-term psychosocial health outcomes. Our findings suggest that both empathy expression and reception are crucial to attaining benefits for cancer patients, each predicting differential cognitive and affective health outcomes. Further, our finding supports the stress-buffering hypothesis such that empathy reception provides a beneficial effect for patients who experienced a higher degree of depression associated with their cancer diagnosis and follow-up treatments.
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http://dx.doi.org/10.1080/10810730.2019.1644401DOI Listing
September 2020

Volume entropy for modeling information flow in a brain graph.

Sci Rep 2019 01 22;9(1):256. Epub 2019 Jan 22.

Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, South Korea.

Brain regions send and receive information through neuronal connections in an efficient way. In this paper, we modelled the information propagation in brain networks by a generalized Markov system associated with a new edge-transition matrix, based on the assumption that information flows through brain networks forever. From this model, we derived new global and local network measures, called a volume entropy and the capacity of nodes and edges on FDG PET and resting-state functional MRI. Volume entropy of a metric graph, a global measure of information, measures the exponential growth rate of the number of network paths. Capacity of nodes and edges, a local measure of information, represents the stationary distribution of information propagation in brain networks. On the resting-state functional MRI of healthy normal subjects, these measures revealed that volume entropy was significantly negatively correlated to the aging and capacities of specific brain nodes and edges underpinned which brain nodes or edges contributed these aging-related changes.
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http://dx.doi.org/10.1038/s41598-018-36339-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342973PMC
January 2019

Effects of robot-assisted gait training in patients with Parkinson's disease: study protocol for a randomized controlled trial.

Trials 2019 Jan 7;20(1):15. Epub 2019 Jan 7.

Department of Rehabilitation Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, Republic of Korea.

Background: Robot-assisted gait training (RAGT) was developed to restore gait function by promoting neuroplasticity through repetitive locomotor training and has been utilized in gait training. However, contradictory outcomes of RAGT have been reported for patients with Parkinson's disease (PD). In addition, the mechanism of the RAGT treatment effect is still unknown. This study aims to investigate the effects of RAGT on gait velocity in patients with PD and to unveil the mechanisms of these effects.

Methods: This is a prospective, single-blind, single-center, randomized controlled trial. Eligible participants will be randomly allocated to: 1) a Walkbot-S™ RAGT group or 2) a treadmill training group. The participants will receive three 45-min sessions of each intervention per week for 4 weeks. Gait speed during RAGT will be targeted to the maximal speed depending on the participant's height; the same principle will be applied to the treadmill training group to match the training intensity. The primary outcome measure is gait speed measured by the 10-Meter Walk Test at a comfortable pace under single-task conditions. Secondary outcomes include dual-task interference, the Berg Balance Scale, Timed Up and Go test, the Korean version of the Falls Efficacy Scale-International, New Freezing of Gait Questionnaire, Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale, and functional connectivity measured by resting-state functional magnetic resonance imaging. Baseline assessments (T0) will be conducted to acquire clinical characteristics and outcome measure values before the intervention. Postintervention assessments (T1) will compare immediate efficacies within 3 days after the intervention. Follow-up assessments (T2) will be conducted 1 month after the intervention. Considering an alpha of 0.05 and a power of 80%, the total number of participants to be recruited is 44.

Discussion: This study will reveal the effect of RAGT using an exoskeletal robot, not only on gait speed, but also on gait automaticity, balance function, fall risk, quality of life, and disease severity. In addition, the study will shed new light on the mechanism of the RAGT effect by evaluating changes in gait automaticity and brain functional networks.

Trial Registration: ClinicalTrials.gov, NCT03490578 . Registered on 21 March 2018.
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http://dx.doi.org/10.1186/s13063-018-3123-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322303PMC
January 2019

Characterization of Brain Dysfunction Induced by Bacterial Lipopeptides That Alter Neuronal Activity and Network in Rodent Brains.

J Neurosci 2018 12 31;38(50):10672-10691. Epub 2018 Oct 31.

Biomaterials and Advanced Drug Delivery Laboratory, Stanford University School of Medicine, Palo Alto, California 94304,

The immunopathological states of the brain induced by bacterial lipoproteins have been well characterized by using biochemical and histological assays. However, these studies have limitations in determining functional states of damaged brains involving aberrant synaptic activity and network, which makes it difficult to diagnose brain disorders during bacterial infection. To address this, we investigated the effect of PamCSK (PAM), a synthetic bacterial lipopeptide, on synaptic dysfunction of female mice brains and cultured neurons in parallel. Our functional brain imaging using PET with [F]fluorodeoxyglucose and [F] flumazenil revealed that the brain dysfunction induced by PAM is closely aligned to disruption of neurotransmitter-related neuronal activity and functional correlation in the region of the limbic system rather than to decrease of metabolic activity of neurons in the injection area. This finding was verified by tissue experiments that analyzed synaptic and dendritic alterations in the regions where PET imaging showed abnormal neuronal activity and network. Recording of synaptic activity also revealed that PAM reorganized synaptic distribution and decreased synaptic plasticity in hippocampus. Further study using neuron cultures demonstrated that PAM decreased the number of presynapses and the frequency of miniature EPSCs, which suggests PAM disrupts neuronal function by damaging presynapses exclusively. We also showed that PAM caused aggregation of synapses around dendrites, which may have caused no significant change in expression level of synaptic proteins, whereas synaptic number and function were impaired by PAM. Our findings could provide a useful guide for diagnosis and treatment of brain disorders specific to bacterial infection. It is challenging to diagnose brain disorders caused by bacterial infection because neural damage induced by bacterial products involves nonspecific neurological symptoms, which is rarely detected by laboratory tests with low spatiotemporal resolution. To better understand brain pathology, it is essential to detect functional abnormalities of brain over time. To this end, we investigated characteristic patterns of altered neuronal integrity and functional correlation between various regions in mice brains injected with bacterial lipopeptides using PET with a goal to apply new findings to diagnosis of brain disorder specific to bacterial infection. In addition, we analyzed altered synaptic density and function using both and experimental models to understand how bacterial lipopeptides impair brain function and network.
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http://dx.doi.org/10.1523/JNEUROSCI.0825-17.2018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6580656PMC
December 2018

Comparison of daily physical activity parameters using objective methods between overweight and normal-weight children.

J Sport Health Sci 2018 Apr 19;7(2):210-217. Epub 2017 Jan 19.

Department of Nutritional Science, National Institute of Health and Nutrition, Tokyo 162-8636, Japan.

Purpose: The purpose of the present study was to determine if there were any differences in various aspects of physical activity such as energy expenditure, intensity, and type of activity between normal-weight and overweight boys.

Methods: Children aged 9-12 years were recruited from 2 elementary schools located in different urban districts in Republic of Korea. The present study included 45 Korean boys, of which 19 were normal-weight and 26 were overweight. Daily physical activity was estimated over the same 1-week study period under free-living conditions using the doubly labeled water (DLW) method and a tri-axial accelerometer. Resting metabolic rate (RMR) was measured using the Douglas bag method and open-circuit indirect calorimetry. We calculated the physical activity level (PAL) as the total energy expenditure (TEE)/RMR.

Results: PAL was not significantly different between the groups. In the accelerometer data, time spent in locomotive moderate-to-vigorous physical activity (MVPA) was significantly lower in overweight boys than in normal-weight subjects, whereas other variables including non-locomotive activity did not differ between groups. In addition, among all participants, time spent in total locomotive activity was significantly associated with PAL. Time spent in locomotive MVPA was significantly associated with PAL.

Conclusion: Overweight boys may be less physically active based on locomotive MVPA, which was positively related with PAL. Our findings suggest that the contribution of locomotive MVPA to the increase in PAL was relatively significant.
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http://dx.doi.org/10.1016/j.jshs.2017.01.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6180554PMC
April 2018

Comparison of daily physical activity parameters using objective methods between overweight and normal-weight children.

J Sport Health Sci 2018 Apr 19;7(2):210-217. Epub 2017 Jan 19.

Department of Nutritional Science, National Institute of Health and Nutrition, Tokyo 162-8636, Japan.

Purpose: The purpose of the present study was to determine if there were any differences in various aspects of physical activity such as energy expenditure, intensity, and type of activity between normal-weight and overweight boys.

Methods: Children aged 9-12 years were recruited from 2 elementary schools located in different urban districts in Republic of Korea. The present study included 45 Korean boys, of which 19 were normal-weight and 26 were overweight. Daily physical activity was estimated over the same 1-week study period under free-living conditions using the doubly labeled water (DLW) method and a tri-axial accelerometer. Resting metabolic rate (RMR) was measured using the Douglas bag method and open-circuit indirect calorimetry. We calculated the physical activity level (PAL) as the total energy expenditure (TEE)/RMR.

Results: PAL was not significantly different between the groups. In the accelerometer data, time spent in locomotive moderate-to-vigorous physical activity (MVPA) was significantly lower in overweight boys than in normal-weight subjects, whereas other variables including non-locomotive activity did not differ between groups. In addition, among all participants, time spent in total locomotive activity was significantly associated with PAL. Time spent in locomotive MVPA was significantly associated with PAL.

Conclusion: Overweight boys may be less physically active based on locomotive MVPA, which was positively related with PAL. Our findings suggest that the contribution of locomotive MVPA to the increase in PAL was relatively significant.
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http://dx.doi.org/10.1016/j.jshs.2017.01.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6180554PMC
April 2018

The association of locomotive and non-locomotive physical activity measured by an accelerometer with functional fitness in healthy elderly men: a pilot study.

J Exerc Nutrition Biochem 2018 Mar;22(1):41-48

Purpose: The purpose of this study was to investigate the relationship of various aspects of daily physical activity, such as the number of steps, time spent in moderate to vigorous intensity physical activity (MVPA), and locomotive and non-locomotive MVPA measured by a triaxial accelerometer, with the functional fitness in healthy elderly men.

Methods: The subjects of this study were 22 healthy elderly men aged over 65 years. The participants wore a triaxial accelerometer for two weeks to estimate their daily physical activities. The level of functional fitness was measured based on "National Fitness Award 100 in Korea" immediately after the measurement of two weeks of daily physical activities.

Results: The results showed that active healthy elderly men with more than 6,500 walking steps per day and more than 60 min per day spent in MVPA showed a significantly higher 2-min marching in place and index of cardiorespiratory endurance compared to less physically active participants. Particularly, locomotive MVPA was significantly associated with cardiorespiratory endurance levels (r = 0.50), whereas non-locomotive MVPA was not associated with other measurements of functional fitness.

Conclusion: Increased MVPA time, especially the locomotive MVPA, can effectively suppress the decrease in cardiorespiratory endurance level in elderly men. However, no association was observed between non-locomotive MVPA, such as household activities, and functional fitness in healthy elderly men.
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http://dx.doi.org/10.20463/jenb.2018.0007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5909071PMC
March 2018

Opinion Leaders in Online Cancer Support Groups: An Investigation of Their Antecedents and Consequences.

Health Commun 2017 02 18;32(2):142-151. Epub 2016 May 18.

d School of Journalism and Mass Communication , Center for Health Enhancement System Studies (CHESS), University of Wisconsin-Madison.

With a focus on the nature and dynamic process of social interactions among breast cancer patients, this study argues that the notion of opinion leaders can be another crucial factor in explaining positive psychosocial health outcomes within computer-mediated social support (CMSS) groups. This study investigates the relationship between opinion leaders and their psychosocial health benefits by considering two overarching questions: (a) Who are the opinion leaders? (b) What role do these opinion leaders play in explaining health outcomes? The data analyzed in this study resulted from merging human-coded content analysis of discussion group messages, action log data analysis of interactive health system usage, and longitudinal survey data. Surveys were administered to 221 women with breast cancer; participants were provided free access to and training for the CMSS groups developed by the Comprehensive Health Support System (CHESS) project. The findings suggest that opinion leaders obtained psychosocial health benefits, such as higher levels of cancer information competence, breast cancer knowledge, and better problem-focused coping strategies. Those who had a higher baseline level of breast cancer knowledge and optimism in coping with challenges in their life were more likely to act as opinion leaders. Implications for research and improving psychosocial interventions for people with health concerns are discussed.
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http://dx.doi.org/10.1080/10410236.2015.1110005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266618PMC
February 2017

Comparison of the clinical characteristics and the results of treatment of leiomyoma in the ciliochoroid and choroid.

Acta Ophthalmol 2017 Mar 25;95(2):217-219. Epub 2016 Apr 25.

Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea.

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http://dx.doi.org/10.1111/aos.12988DOI Listing
March 2017

Predicting Retweeting Behavior on Breast Cancer Social Networks: Network and Content Characteristics.

J Health Commun 2016 23;21(4):479-86. Epub 2016 Mar 23.

c Department of Advertising and Public Relations , Henry W. Grady College of Journalism and Mass Communication, University of Georgia , Athens , Georgia , USA.

This study explored how social media, especially Twitter, serves as a viable place for communicating about cancer. Using a 2-step analytic method that combined social network analysis and computer-aided content analysis, this study investigated (a) how different types of network structures explain retweeting behavior and (b) which types of tweets are retweeted and why some messages generate more interaction among users. The analysis revealed that messages written by users who had a higher number of followers, a higher level of personal influence over the interaction, and closer relationships and similarities with other users were retweeted. In addition, a tweet with a higher level of positive emotion was more likely to be retweeted, whereas a tweet with a higher level of tentative words was less likely to be retweeted. These findings imply that Twitter can be an effective tool for the dissemination of health information. Theoretical and practical implications for psychosocial interventions for people with health concerns are discussed.
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http://dx.doi.org/10.1080/10810730.2015.1103326DOI Listing
August 2016

The acute respiratory exposure by intratracheal instillation of Sprague-Dawley rats with diesel particulate matter induces retinal thickening.

Cutan Ocul Toxicol 2016 Dec 11;35(4):275-80. Epub 2015 Dec 11.

c Department of Pathology , Eulji University , Seoul , Korea.

Context: Adverse health effects of ambient particulate matter (PM) have been demonstrated in humans, mostly in terms of respiratory and cardiovascular events. However, whether ambient particle could affect the eyes had not been fully revealed.

Objective: This study investigated the effect of acute respiratory exposure to PM on eyes.

Methods: Diesel exhaust product (DEP) of 200 mg/l was given endotracheally in Sprague-Dawley rats for 1 h (n = 12) and compared to normal control (n = 4). We enucleated eyes and histologically evaluated. Immunohistochemical stains for CD34 (Dako, Glostrup, Denmark, 1:50) and Ki-67 (DakoCytomation, Glostrup, Denmark, 1:150) were performed to evaluate new vessel formation and proliferation activity.

Results: After endotracheal DEP exposure, the thickness of retina was significantly increased to 258 ± 96 μm in DEP group, while that of control was 113 ± 9 μm (p = 0.025). Among the retinal structure, inner plexiform, inner and outer nuclear and rod/cone cell layers were significantly thickened (p = 0.00, 0.017, 0.004, 0.001, respectively). The outer plexiform layer of DEP group showed a tendency of thickening, but statistically insignificant. The afferent fiber and ganglion cell layer showed no thickness difference between two groups, but prominent capillaries with congestion were noted in DEP group. Neither neovascularization nor increased proliferation was demonstrated on CD34 and Ki-67 immunohistochemical staining in DEP group.

Conclusion: This study shows that the acute respiratory exposure of ambient PM increased retinal thickness, especially inner plexiform, inner and outer nuclear and rod/cone cell layers. We thought that increase of retinal thickness in DEP group resulted in hypoxia-induced edema.
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http://dx.doi.org/10.3109/15569527.2015.1104329DOI Listing
December 2016

Association of the Extent of Atrophic Gastritis With Specific Dyspeptic Symptoms.

J Neurogastroenterol Motil 2015 Oct;21(4):528-36

Department of Gastroenterology, Ajou University School of Medicine, Suwon, Gyeonggido, Korea.

Background/aims: It remains unclear whether atrophic gastritis can affect dyspeptic symptoms. We aimed to investigate whether the extent of atrophic gastritis is associated with specific dyspeptic symptoms.

Methods: Consecutive adults in a routine health-checkup program were enrolled in the study. The extent of atrophic gastritis was classified into 3 groups based on the Kimura-Takemoto criteria; the gastritis with no or little atrophy (group A: C0), the gastritis with atrophy mainly in the antrum (group B: C1 and C2), and the gastritis with atrophy in the large area of the corpus (group C: C3 and O). Upper gastrointestinal symptoms were categorized into "typical reflux symptoms," "epigastric pain syndrome (EPS)-related symptoms," and "postprandial distress syndrome (PDS)-related symptoms."

Results: A total of 1827 patients (1009 males, mean age 45.1 years) were included in the analysis. The subgroups of atrophic gastritis were as follows: group A (n = 1218, 66.7%), group B (n = 392, 21.4%), and group C (n = 217, 11.9%). Typical reflux, EPS-related, and PDS-related symptoms were present in 10.5%, 19.8%, and 16.2% of the subjects, respectively. PDS-related and EPS-related symptoms were significantly more prevalent in the group C of male patients and the group B of female patients, respectively, compared with other groups. PDS-related and EPS-related symptoms were independently associated with the group C in males (OR, 2.123; 95% CI, 1.090-4.136) and the group B in females (OR, 2.571; 95% CI, 1.319-5.025), respectively.

Conclusions: The extent of atrophic gastritis appears to affect the generation of specific dyspeptic symptoms in a gender-dependent manner.
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http://dx.doi.org/10.5056/jnm15074DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4622135PMC
October 2015

Optimal likelihood-ratio multiple testing with application to Alzheimer's disease and questionable dementia.

BMC Med Res Methodol 2015 Jan 30;15. Epub 2015 Jan 30.

Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea.

Background: Controlling the false discovery rate is important when testing multiple hypotheses. To enhance the detection capability of a false discovery rate control test, we applied the likelihood ratio-based multiple testing method in neuroimage data and compared the performance with the existing methods.

Methods: We analysed the performance of the likelihood ratio-based false discovery rate method using simulation data generated under independent assumption, and positron emission tomography data of Alzheimer's disease and questionable dementia. We investigated how well the method detects extensive hypometabolic regions and compared the results to those of the conventional Benjamini Hochberg-false discovery rate method.

Results: Our findings show that the likelihood ratio-based false discovery rate method can control the false discovery rate, giving the smallest false non-discovery rate (for a one-sided test) or the smallest expected number of false assignments (for a two-sided test). Even though we assumed independence among voxels, the likelihood ratio-based false discovery rate method detected more extensive hypometabolic regions in 22 patients with Alzheimer's disease, as compared to the 44 normal controls, than did the Benjamini Hochberg-false discovery rate method. The contingency and distribution patterns were consistent with those of previous studies. In 24 questionable dementia patients, the proposed likelihood ratio-based false discovery rate method was able to detect hypometabolism in the medial temporal region.

Conclusions: This study showed that the proposed likelihood ratio-based false discovery rate method efficiently identifies extensive hypometabolic regions owing to its increased detection capability and ability to control the false discovery rate.
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http://dx.doi.org/10.1186/1471-2288-15-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4417288PMC
January 2015

Morphological brain network assessed using graph theory and network filtration in deaf adults.

Hear Res 2014 Sep 10;315:88-98. Epub 2014 Jul 10.

Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea; Interdisciplinary Program in Cognitive Science, Seoul National University, Seoul, Republic of Korea; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine or College of Pharmacy, Seoul National University, Seoul, Republic of Korea. Electronic address:

Prolonged deprivation of auditory input can change brain networks in pre- and postlingual deaf adults by brain-wide reorganization. To investigate morphological changes in these brains voxel-based morphometry, voxel-wise correlation with the primary auditory cortex, and whole brain network analyses using morphological covariance were performed in eight prelingual deaf, eleven postlingual deaf, and eleven hearing adults. Network characteristics based on graph theory and network filtration based on persistent homology were examined. Gray matter density in the primary auditor cortex was preserved in prelingual deafness, while it tended to decrease in postlingual deafness. Unlike postlingual, prelingual deafness showed increased bilateral temporal connectivity of the primary auditory cortex compared to the hearing adults. Of the graph theory-based characteristics, clustering coefficient, betweenness centrality, and nodal efficiency all increased in prelingual deafness, while all the parameters of postlingual deafness were similar to the hearing adults. Patterns of connected components changing during network filtration were different between prelingual deafness and hearing adults according to the barcode, dendrogram, and single linkage matrix representations, while these were the same in postlingual deafness. Nodes in fronto-limbic and left temporal components were closely coupled, and nodes in the temporo-parietal component were loosely coupled, in prelingual deafness. Patterns of connected components changing in postlingual deafness were the same as hearing adults. We propose that the preserved density of auditory cortex associated with increased connectivity in prelingual deafness, and closer coupling between certain brain areas, represent distinctive reorganization of auditory and related cortices compared with hearing or postlingual deaf adults. The differential network reorganization in the prelingual deaf adults could be related to the absence of auditory speech experience.
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http://dx.doi.org/10.1016/j.heares.2014.06.007DOI Listing
September 2014

Estimating free-living human energy expenditure: Practical aspects of the doubly labeled water method and its applications.

Nutr Res Pract 2014 Jun 15;8(3):241-8. Epub 2014 May 15.

Department of Food and Nutrition, Keimyung University, Daegu 704-701, Korea.

The accuracy and noninvasive nature of the doubly labeled water (DLW) method makes it ideal for the study of human energy metabolism in free-living conditions. However, the DLW method is not always practical in many developing and Asian countries because of the high costs of isotopes and equipment for isotope analysis as well as the expertise required for analysis. This review provides information about the theoretical background and practical aspects of the DLW method, including optimal dose, basic protocols of two- and multiple-point approaches, experimental procedures, and isotopic analysis. We also introduce applications of DLW data, such as determining the equations of estimated energy requirement and validation studies of energy intake.
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http://dx.doi.org/10.4162/nrp.2014.8.3.241DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4058556PMC
June 2014

Protein conformational dynamics dictate the binding affinity for a ligand.

Nat Commun 2014 Apr 24;5:3724. Epub 2014 Apr 24.

Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon 305-701, Korea.

Interactions between a protein and a ligand are essential to all biological processes. Binding and dissociation are the two fundamental steps of ligand-protein interactions, and determine the binding affinity. Intrinsic conformational dynamics of proteins have been suggested to play crucial roles in ligand binding and dissociation. Here, we demonstrate how protein dynamics dictate the binding and dissociation of a ligand through a single-molecule kinetic analysis for a series of maltose-binding protein mutants that have different intrinsic conformational dynamics and dissociation constants for maltose. Our results provide direct evidence that the ligand dissociation is determined by the intrinsic opening rate of the protein.
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http://dx.doi.org/10.1038/ncomms4724DOI Listing
April 2014

Achalasia in Korea: an epidemiologic study using a national healthcare database.

J Korean Med Sci 2014 Apr 1;29(4):576-80. Epub 2014 Apr 1.

Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea.

Owing to the rarity of the disease, epidemiologic information on achalasia is limited. This study aimed to investigate the epidemiology and treatment patterns of achalasia in the population of Korea using a national healthcare database. The diagnostic code K22.0 of the International Classification of Diseases was used to identify cases of achalasia between 2007 and 2011. Treatment modalities for achalasia were identified using the electronic data interchange codes Q7642 or Q7641 for balloon dilation and QA421 or QA422 for esophago-cardiomyotomy. A total of 3,105 patients with achalasia (1,447 men; mean age, 52.5 yr) were identified between 2007 and 2011, indicating a prevalence of 6.29/100,000 (95% confidence interval [CI], 4.94-7.66) during this 5-yr period. A total of 191 incident cases of achalasia (82 men; mean age, 49.5 yr), which were not diagnosed as achalasia in the previous 4 yr, were detected in 2011, indicating an incidence of 0.39/100,000 (95% CI, 0.15-0.63) for that year. During the study period, balloon dilation therapy was performed a total of 975 times in 719 patients, and surgical esophago-cardiomyotomy was performed once per patient in 17 patients. This is the first population-based epidemiologic study of achalasia in Korea.
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http://dx.doi.org/10.3346/jkms.2014.29.4.576DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991803PMC
April 2014
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