Publications by authors named "Jong-Moon Hwang"

29 Publications

  • Page 1 of 1

Step-by-step inpatient rehabilitation for critical illness after coronavirus disease 2019: A CARE-compliant case report.

Medicine (Baltimore) 2021 Jun;100(23):e26317

Department of Rehabilitation Medicine, Kyungpook National University Hospital.

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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http://dx.doi.org/10.1097/MD.0000000000026317DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202574PMC
June 2021

Does polydeoxyribonucleotide has an effect on patients with tendon or ligament pain?: A PRISMA-compliant meta-analysis.

Medicine (Baltimore) 2021 May;100(19):e25792

Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.

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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http://dx.doi.org/10.1097/MD.0000000000025792DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8133136PMC
May 2021

Inversion Table Fall Injury, the Phantom Menace: Three Case Reports on Cervical Spinal Cord Injury.

Healthcare (Basel) 2021 Apr 22;9(5). Epub 2021 Apr 22.

Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea.

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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http://dx.doi.org/10.3390/healthcare9050492DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8143462PMC
April 2021

Submandibular Push Exercise Using Visual Feedback from a Pressure Sensor in Patients with Swallowing Difficulties: A Pilot Study.

Healthcare (Basel) 2021 Apr 1;9(4). Epub 2021 Apr 1.

Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea.

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. 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. 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 ( < 0.05). The maximum pressure and the area of the pressure-time graph improved from the first to the fourth session ( < 0.05). The values were maintained after the fourth session, and there was no significant difference between the fourth and the fifth exercise ( > 0.05). There was no significant difference between successful and non-successful groups, except for the Modified Barthel Index ( < 0.05). 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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http://dx.doi.org/10.3390/healthcare9040407DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8065833PMC
April 2021

Effectiveness of Intravenous Immunoglobulin for Management of Pain in Patients with Postpolio Syndrome.

Pain Res Manag 2021 20;2021:6637705. Epub 2021 Mar 20.

Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.

Objective: Many patients with postpolio syndrome (PPS) experience pain. In this study, we aimed to review previous studies to investigate the effectiveness of intravenous immunoglobulin (IVIG) for managing pain in patients with PPS. We performed a narrative review.

Methods: In PubMed, we searched for the keywords ((Immunoglobulin OR IVIG) AND (poliomyelitis OR poliomyelitis syndrome)). We included articles in which IVIG was infused in patients with PPS and pain severity was measured before and after treatment.

Results: In the results, five articles (4 randomized controlled trials and 1 prospective observational study) were included in this review. Four of the studies reported that IVIG had a positive pain-reducing effect in patients with PPS. In addition, 4 studies evaluated the outcomes related to muscle strength and function. Of these studies, 3 showed some improvement in measurements for muscle strength and function.

Conclusion: In conclusion, IVIG might be one of the beneficial options for managing pain in PPS. Pain reduction might be responsible for the improvement of muscle strength or function. To confirm the benefits of IVIG in reducing pain, more high-quality studies are required.
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http://dx.doi.org/10.1155/2021/6637705DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007355PMC
June 2021

The Influencing Factors of Gender Differences on Mental Burdens in Young Physiotherapists and Occupational Therapist.

Int J Environ Res Public Health 2021 03 11;18(6). Epub 2021 Mar 11.

Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea.

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 ( = 325; male = 131; female = 194. Age: 20-29 years old, = 178; ≥30 years old, = 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, = 0.015) and job stress (β = 0.162, = 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 (R = 0.156, = 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, < 0.001) and females (β = 0.373, = 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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http://dx.doi.org/10.3390/ijerph18062858DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8000823PMC
March 2021

Comparison of three different types of exercises for selective contractions of supra- and infrahyoid muscles.

Sci Rep 2021 Mar 30;11(1):7131. Epub 2021 Mar 30.

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.

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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http://dx.doi.org/10.1038/s41598-021-86502-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8010107PMC
March 2021

COVID-19 Outbreak and Its Association with Healthcare Workers' Emotional Stress: a Cross-Sectional Study.

J Korean Med Sci 2020 Oct 26;35(41):e372. Epub 2020 Oct 26.

Department of Occupational and Environmental Medicine, Yeungnam University Hospital, Daegu, Korea.

Background: The coronavirus disease 2019 (COVID-19) outbreak has exposed healthcare workers to extreme physical workloads and psychological challenges. Thus, we aimed to assess the immediate correlates of emotional stress and to identify which specific jobs, departments, and exposure types are risk factors for emotional stress in healthcare workers.

Methods: In this cross-sectional study conducted from April 2 to 10, 2020, university hospital workers were administered self-reported questionnaires that covered general characteristics and included the Patient Health Questionnaire, Generalized Anxiety Disorder scale, and a visual analog scale. At-risk groups for depression and anxiety were identified, and the odds ratios for depression and anxiety were analyzed after adjusting for age, gender, education, marital status, and duration of employment.

Results: The data of 1,003 participants were analyzed. Of these, 14.2% worked in wards for confirmed COVID-19 cases and 15.2% had had direct contact with these patients. Treating patients with COVID-19 was associated with depression and anxiety, while dealing with COVID-19 test samples was associated with depression. Exposure to random or unspecified patients was also associated with depression. Lastly, social rejection and other negative experiences were associated with depression and anxiety.

Conclusion: The COVID-19 outbreak is correlated with healthcare workers' emotional stress, and specific types of jobs and duties involving close contact with these patients can be risk factors. Interestingly, even low-exposure groups reported significant depression and anxiety as a result of social stigma and uncertainty. Adequate and timely management measures for emotional stress are required for vulnerable and at-risk groups.
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http://dx.doi.org/10.3346/jkms.2020.35.e372DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590650PMC
October 2020

Machine learning analysis to automatically measure response time of pharyngeal swallowing reflex in videofluoroscopic swallowing study.

Sci Rep 2020 09 7;10(1):14735. Epub 2020 Sep 7.

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.

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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http://dx.doi.org/10.1038/s41598-020-71713-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7477563PMC
September 2020

Fasting Plasma Glucose Level Independently Predicts the Mortality of Patients with Coronavirus Disease 2019 Infection: A Multicenter, Retrospective Cohort Study.

Endocrinol Metab (Seoul) 2020 09 26;35(3):595-601. Epub 2020 Aug 26.

Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.

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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http://dx.doi.org/10.3803/EnM.2020.719DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7520580PMC
September 2020

Relationship between the actual fine dust concentration and media exposure that influenced the changes in outdoor activity behavior in South Korea.

Sci Rep 2020 07 20;10(1):12006. Epub 2020 Jul 20.

Department of Rehabilitation Medicine, Kyungpook National University Hospital, 200 Dongduk-ro Jung-gu, Daegu, 700-721, South Korea.

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/m; 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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http://dx.doi.org/10.1038/s41598-020-68580-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7371889PMC
July 2020

Effect of the submandibular push exercise using visual feedback from pressure sensor: an electromyography study.

Sci Rep 2020 07 16;10(1):11772. Epub 2020 Jul 16.

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.

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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http://dx.doi.org/10.1038/s41598-020-68738-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366651PMC
July 2020

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 07 11;17(14). Epub 2020 Jul 11.

Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea.

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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http://dx.doi.org/10.3390/ijerph17145001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399933PMC
July 2020

Neurological diseases as mortality predictive factors for patients with COVID-19: a retrospective cohort study.

Neurol Sci 2020 Sep 8;41(9):2317-2324. Epub 2020 Jul 8.

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.

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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http://dx.doi.org/10.1007/s10072-020-04541-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342552PMC
September 2020

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 Nov;98(48):e18137

Department of Rehabilitation Medicine, Kyungpook National University Hospital.

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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http://dx.doi.org/10.1097/MD.0000000000018137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6890358PMC
November 2019

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 Nov;98(46):e17959

Department of Rehabilitation Medicine, Kyungpook National University Hospital.

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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http://dx.doi.org/10.1097/MD.0000000000017959DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6867788PMC
November 2019

An Alternative Approach to the Ultrasound-Guided Intra-Articular Hip Injection.

PM R 2020 01 4;12(1):104-106. Epub 2019 Dec 4.

Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea.

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http://dx.doi.org/10.1002/pmrj.12277DOI Listing
January 2020

Ultrasound-guided peri-brachial plexus polydeoxyribonucleotide injection for a patient with postherpetic brachial plexopathy: A case report.

Medicine (Baltimore) 2019 Aug;98(31):e16694

Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea.

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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http://dx.doi.org/10.1097/MD.0000000000016694DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709125PMC
August 2019

Changes in Pectoral Muscle Volume During Subacute Period after Radiation Therapy for Breast Cancer: A Retrospective up to 4-year Follow-up Study.

Sci Rep 2019 05 7;9(1):7038. Epub 2019 May 7.

Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea.

Radiotherapy (RT) is an effective treatment for managing breast cancer patients with breast conserving surgery, but patients may experience radiation-induced shoulder problems. Even though the course of shoulder morbidity is unknown, pectoral muscle changes after radiotherapy can be a major cause of shoulder problems. Twenty-two patients treated with RT for unilateral breast cancer were included in the study. All patients underwent serial computed tomography (CT) imaging before and immediately after RT, as well as 2 months, 6 months, 2 years, and 3-4 years after RT. These CT scans were used to compare muscle volume changes. The pectoral muscle volume and muscle volume surrounding the scapular measurement was performed using 3D modelling after segmentation of the CT scans. In all patients, the pectoral muscle volume increased during the 2 months after RT, and there was continuous volume reduction from 2-48 months after RT. Changes in muscle volume ratio over time were analysed by repeated measure ANOVA and it was found that there was a significant change in the pectoral muscle volume (p < 0.001) from Just before RT and Immediately after RT at 2 month after RT. On the other hand, the changes in the muscle volume of the surrounding scapular were not significant.
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http://dx.doi.org/10.1038/s41598-019-43163-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6505029PMC
May 2019

An unusual complication of sacral nerve root injury following bone marrow harvesting: a case report.

BMC Cancer 2019 Apr 11;19(1):347. Epub 2019 Apr 11.

Department of Rehabilitation Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea.

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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http://dx.doi.org/10.1186/s12885-019-5567-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458794PMC
April 2019

An unusual complication of sacral nerve root injury following bone marrow harvesting: a case report.

BMC Cancer 2019 Apr 11;19(1):347. Epub 2019 Apr 11.

Department of Rehabilitation Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea.

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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http://dx.doi.org/10.1186/s12885-019-5567-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458794PMC
April 2019

Association between initial opioid use and response to a brief interdisciplinary treatment program in fibromyalgia.

Medicine (Baltimore) 2019 Jan;98(1):e13913

Department of Rehabilitation Medicine, Kyungpook National University Hospital.

Background: To evaluate the association between opioid use and treatment outcome (symptom severity, quality of life [QOL]) after a brief interdisciplinary fibromyalgia treatment program (FTP).

Method: Subjects (n = 971) with fibromyalgia participated in the FTP. They filled out the Fibromyalgia Impact Questionnaire (FIQ) and the Short Form-36 Health Status Questionnaire (SF-36) at baseline and 6 to 12 months after the FTP. Post-treatment changes in FIQ and SF-36 scores were compared after stratifying the participants into opioid user and non-opioid user groups.

Results: A total of 236 patients (24.3%) were opioid users. Compared with non-opioid users, the opioid users had worse symptom severity measured using FIQ total score (p < .001) and all subscales at baseline and post treatment, as well as worse QOL measured using all SF-36 subscales and physical and mental components. Comparison of least-square means of mean change of QOL between opioid users and non-opioid users after analysis of covariance adjusted patient characteristics and baseline scores showed that the FIQ subscale scores of physical impairment (p < .05), job ability (p < .05), and fatigue (p < .05) were significantly less improved in the opioid users compared with the non-opioid users. Moreover, the SF-36 subscale score of general health perception (p < .05) was significantly less improved in the opioid users compared with non-opioid users. However, post-treatment changes in mean scores for QOL subscale generally did not significantly differ in both groups.

Conclusions: Opioid use did not affect response to the FTP, as measured using the FIQ total score or SF-36 physical and mental component summary scores. Furthermore, the opioid user group showed less improvement in the FIQ subscale scores of physical impairment, job ability, and fatigue and in the SF-36 subscale scores of general health perception.
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http://dx.doi.org/10.1097/MD.0000000000013913DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344169PMC
January 2019

The center of pressure and ankle muscle co-contraction in response to anterior-posterior perturbations.

PLoS One 2018 29;13(11):e0207667. Epub 2018 Nov 29.

Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea.

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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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0207667PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6264860PMC
April 2019

Is abdominal hollowing exercise using real-time ultrasound imaging feedback helpful for selective strengthening of the transversus abdominis muscle?: A prospective, randomized, parallel-group, comparative study.

Medicine (Baltimore) 2018 Jul;97(27):e11369

Department of Rehabilitation Medicine, Daegu Fatima Hospital Department of Rehabilitation Medicine, New Life Hospital Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea.

Despite the importance of strengthening of the transversus abdominis (TrA) muscle in individuals with low back pain, the effect of real-time ultrasound imaging on maintenance in selective strengthening of abdominal hallowing exercise (AHE) performance has not been investigated. So, the aim of this study was to investigate the effects of AHE with real-time ultrasound imaging feedback on selective reinforcing the TrA muscle.Twenty healthy subjects were enrolled prospectively and randomized to train AHE for 2 weeks either by conventional feedback (group A) or by visual feedback from real-time ultrasound imaging additional to conventional feedback (group B). The changes in thickness of TrA, internal oblique abdominal muscle (IO), and external oblique abdominal muscle (EO) were measured using the ultrasonography. The changes in muscle activities of TrA-IO and EO were measured using surface electromyography.The thickness of TrA, IO, and EO muscles in resting was not significantly changed in both groups A and B. However, the ratio of root mean square (RMS) values of TrA-IO/EO muscles, which mirrors selective contraction of TRA-IO muscles against EO muscle, was significantly higher in group B than in group A.In healthy subjects, training with AHE using real-time ultrasound imaging feedback may be a useful additional method to conventional feedback for strengthening the TrA muscles selectively.
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http://dx.doi.org/10.1097/MD.0000000000011369DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6076057PMC
July 2018

Predictability of severity of disc degeneration and disc protrusion using horizontal displacement of cervical dynamic radiographs: A retrospective comparison study with MRI.

Medicine (Baltimore) 2018 Jun;97(25):e11098

Department of Rehabilitation Medicine, Kyungpook National University School of Medicine, Kyungpook National University Hospital, Daegu Department of Neurology, School of Medicine, Kyungpook National University Chilgok Hospital Division of Rheumatology, Department of Internal Medicine, Kyungpook National University School of Medicine Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea.

The aim of this study is to investigate the usefulness of flexion-extension (dynamic) radiographs in evaluating the severity of disc degeneration and disc protrusion in cervical magnetic resonance image (MRI). Patients complaining of neck or arm pain with no prior surgical history and who had undergone both cervical MRI and dynamic radiographs were included in this study. The following patients were excluded: those who had any history of trauma, autoimmune disease such as rheumatoid arthritis or ankylosing spondylitis, prior cervical fracture or prior cervical spine surgery. Based on these criteria, 161 patients who visited our department for neck pain or upper extremity radicular symptoms were initially included retrospectively. Among them, 69 patients were excluded due to the lack of cervical MRI or dynamic radiographs. Therefore, a total of 92 patients were included for analysis in this study. The maximal diameter of disc protrusion in sagittal or axial MRI, the severity of cervical disc degeneration, and segmental horizontal displacement in dynamic cervical radiographs are the main outcome measurements. In the results of this study, the extension radiograph of C5/6 had the highest sensitivity (93.33%) and specificity (100%) in predicting cervical disc protrusion followed by C4/5 (sensitivity; 77.28%, specificity 92.86%) among the dynamic radiographs. Segmental horizontal displacement at the C3/4, C4/5, and C5/6 level in the neutral and extension radiographs had a significant correlation with the severity of cervical disc degeneration in MRI (P < .05). At the C6/7 level, however, only extension radiograph had a significant correlation with the severity of cervical disc degeneration in the MRI (P < .05). In conclusion, if MRI is not available in a primary clinical setting, dynamic cervical radiographs may be useful in predicting the severity of degenerative disc and disc protrusion in cervical MRI. Among the dynamic cervical radiographs, the extension radiograph was the most sensitive for predicting the severity of cervical disc degeneration and disc protrusion, especially at the C3/4, C4/5, C5/6, and C6/7 levels in MRI.
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http://dx.doi.org/10.1097/MD.0000000000011098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024478PMC
June 2018

Recommendation of Nasogastric Tube Removal in Acute Stroke Patients Based on Videofluoroscopic Swallow Study.

Ann Rehabil Med 2017 Feb 28;41(1):9-15. Epub 2017 Feb 28.

Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea.; Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea.

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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http://dx.doi.org/10.5535/arm.2017.41.1.9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5344831PMC
February 2017

Change of Brain Functional Connectivity in Patients With Spinal Cord Injury: Graph Theory Based Approach.

Ann Rehabil Med 2015 Jun 30;39(3):374-83. Epub 2015 Jun 30.

Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea.

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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http://dx.doi.org/10.5535/arm.2015.39.3.374DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4496508PMC
June 2015

Effect of dominant hand paralysis on quality of life in patients with subacute stroke.

Ann Rehabil Med 2014 Aug 28;38(4):450-7. Epub 2014 Aug 28.

Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea. ; Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea.

Objective: To evaluate the degree to which the paralysis of a dominant hand affects quality of life (QOL) in patients with subacute stroke.

Methods: We recruited 75 patients with subacute hemiplegic stroke. Patients were divided into two groups according to the location of the lesion and the side of the dominant hand. Group 1 consisted of patients whose strokes affected the dominant hand (i.e., right hemiplegia and right dominant hand or left hemiplegia and left dominant hand). Group 2 consisted of patients whose strokes affected the non-dominant hand (i.e., left hemiplegia and right dominant hand or right hemiplegia and left dominant hand). The primary outcome measure was the Short-Form 36-Item Health Survey (SF-36), which was used to evaluate health-related QOL. Secondary outcomes were scores on the Modified Barthel Index (MBI) and Beck Depression Inventory (BDI).

Results: We did not find any statistically significant differences between the groups in any SF-36 domain including the summaries of physical and mental component. Similarly, the MBI and BDI scores were not significantly different between the groups.

Conclusion: The effect of paralysis on the dominant hand and QOL in patients with subacute stroke was not significantly different from the effect of paralysis on the non-dominant hand.
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http://dx.doi.org/10.5535/arm.2014.38.4.450DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4163584PMC
August 2014

Local neurokinin-1 receptor in the knee joint contributes to the induction, but not maintenance, of arthritic pain in the rat.

Neurosci Lett 2002 Mar;322(1):21-4

Department of Physiology, College of Medicine and Neuroscience Research Institute, Medical Science Research Center, Korea University, 126-1 Anam-dong 5 ga, Sungbuk-gu, Seoul 136-075, South Korea.

Substance P is known to exert various pro-inflammatory effects that are mediated by neurokinin-1 (NK-1) receptor in peripheral tissues. This study examined the effect of the NK-1 receptor antagonist cis-2-[diphenylmethyl]-N-[(2-iodophenyl)-1-azabicyclo[2.2.2]octan-3-amine] (L-703,606) on nociceptive response following carrageenan injection (2%, 50 microl) into the knee joint cavity of the right hind leg. L-703,606 injection (0.1 or 1 mM, 50 microl) into the same joint cavity immediately before the carrageenan injection significantly reduced the nociceptive response. However, antagonist treatment at 5 h after carrageenan injection was ineffective in alleviating nociception. Neither intraperitoneal injection of the antagonist (1 mM, 50 microl) immediately before the carrageenan injection was effective. These results suggest that local NK-1 receptor contributes to the induction, but not maintenance, of arthritic pain.
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http://dx.doi.org/10.1016/s0304-3940(02)00070-8DOI Listing
March 2002
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