• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.83-91
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• 2017

Purpose: To investigate the clinical outcomes of distal hook augmentation using a pedicle screw in thoracolumbar fusion in elderly patients. Materials and Methods: This retrospective multicenter study recruited 20 patients aged 65 years or older, who underwent anterior support and long level posterior fusion in the thoracolumbar junction with a follow-up of one year. To assess the effect of distal hook augmentation, the patients were divided into two groups; the pedicle screw with hook group (PH group, n=10) and the pedicle screw alone group (PA group, n=10). Results: The average age was 72.4 years (65-83 years). The average fusion segment was 4.6 segments (3-6 segments). There were no significant differences in age, sex, causative diseases, bone mineral density of lumbar and proximal femur, number of patients with osteoporosis, and number of fused segments between the two groups (p≥0.05). At 1 year follow-up after surgery, parameters related with distal screw pullout were significantly worse in the PA group. No patients in the PH group had distal screw pullout. However, six patients (60%, 6/10) in the PA group had distal screw pullout. There were no significant differences in the progression of distal junctional kyphosis between the two groups. Conclusion: Distal hook augmentation is an effective procedure in protecting distal pedicle screws against the pullout when long level thoracolumbar fusion was performed in elderly patients aged 65 years or older.

• The Journal of the Society of Stroke on Korean Medicine
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• v.11 no.1
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• pp.9-17
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• 2010

Objectives : This study was aimed to evaluate the current status of East-West integrated treatment in stroke and brain disease and to discuss further plans. Methods : The medical records of patients who visited the stroke and brain disease center at Kyung Hee University, East-West Neo Medical Center from May 2006 to August 2010 were evaluated. The general characteristics of patients who underwent integrated treatment, trend in the number of cross referrals were initially evaluated. Later major disorders, the reasons of referrals and the number of visits in outpatients were analyzed. Results : 1. 3496 patients were referred from the eastern medical hospital to the western medical hospital and 2440 patients from the western medical hospital to the eastern medical hospital. The number of patients reached a peak alter the opening of the hospital and has decreased from then on. Referrals of female patients were more than those of male patients and patients over 50 years old were the most. 2. Admitted patients with stroke of chronic stage were most commonly referred from the eastern medical hospital to the western medical hospital and cerebral infarction was most common from the western medical hospital to the eastern medical hospital. Among the outpatients cerebral infarction topped from east to west, and stroke of chronic stage from west to east. 3. 36.6% of the patients from east to west received integrated treatment more than 3 times and 28.6% from west to east. Headache was the second most common reason to be referred from west to east and 36.7% of patients didn't continue to have either of the treatment and 30.3% received eastern treatment only, Conclusions: According to this study, chronic stroke management was successfully performed in the outpatient clinic in the form of East-West integration treatment. Further research on other diseases such as headache is recommended.

• The Journal of Korean Academy of Sensory Integration
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• v.21 no.1
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• pp.47-58
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• 2023

Objective : This study aimed to investigate the current status and actual use of assessment tools by institutions in the field of occupational therapy with children in Korea. Methods : The study was conducted with 67 occupational therapists working with children in Korea. To investigate the use of evaluation tools by area, knowledge of the evaluation tools, and desire to participate in further education, the questionnaires used in studies by Lee, Hong, and Park (2018) and Kim (2015) were modified and supplemented according to the child evaluation tools currently in usein institutions in Korea. For data collection, we distributed Google questionnaires to child occupational therapists for 3 weeks using convenience sampling. Excel was used to analyze the use of the evaluation tools according to institution. Technical statistics and frequency analyses were used to verify the general characteristics, evaluation-related information, status of evaluation tool use, knowledge levels relating to evaluation tools, and desire to participate in education. A t-test was used for the evaluation tool status. Results : Welfare centers used the most evaluation tools, with an average of 11.1, followed by university hospitals, rehabilitation hospitals, clinics, and daycare centers. There were differences in the choice of tools used, hospital with the Jebsen-Taylor hand function test and the Wee-FIM (Functional Independence Measure) being the most frequently applied. Centers, daycare centers, and welfare center the Sensory Profile test and clinical observation were also used often. Regarding the level of knowledge of evaluation tools and the desire to participate further in education, 30 (44.8%) of the respondents had not completed their education, and 42 (62.7%) rated their knowledge level as generally low. When asked about the importance of using a manual to guide them in their use of evaluation tools, 66 (98.6%) answered positively, and 66 (98.6%) answered that they needed specialized training in the use of evaluation tools. Conclusion : This study makes it possible to understand the use and status of evaluation tools as used by different institutions in Korea in the field of child occupational therapy It is anticipated that it will provide the basis for introducing existing evaluation tools and preparing new evaluation tools to be used in this field in Korea.

• Journal of Life Science
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• v.33 no.7
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• pp.531-537
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• 2023

Intracellular and axonal transport is mediated by microtubule-dependent motor proteins, such as kinesins and cytoplasmic dynein. Kinesin moves along the microtubule to the positive end of the microtubule, while dynein moves to the negative end of the microtubule. Kinesin-1 was first identified as a kinesin superfamily protein (KIF) that functions in the intracellular transport of various cargoes, including organelles, neurotransmitter receptors, and mRNA-protein complexes, through interactions between the carboxyl (C)-terminal domain and the cargo. It interacts with other cargoes, but the adapter/scaffold proteins that mediate between kinesin-1 and the cargo have yet to be fully identified. In this study, a yeast two-hybrid screen was used to identify adapter proteins that interact with the C-terminal region of KIF5A. We found an association between the C-terminal region of KIF5A and the cyclin-dependent kinase 2-associated protein 1 (CDK2AP1), originally identified in malignant hamster oral keratinocytes. CDK2AP1 bound to the C-terminal region of KIF5A and did not interact with KIF3A (the motor of kinesin-2), KIF5B, KIF5C, and kinesin light chain 1 (KLC1). The C-terminal region of CDK2AP1 is essential for its interaction with KIF5A. When co-expressed in HEK-293T cells, CDK2AP1 and kinesin-1 co-immunoprecipitated and co-localized in the cells. These results suggest that the KIF5A-CDK2AP1 interaction serves as an adapter protein connecting kinesin-1 and the cargo when kinesin-1 transports cargo in cells.

• 재활복지
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• v.14 no.3
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• pp.225-256
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• 2010

This study aims to provide the basic data of the rehabilitation program for the schoolchild with intellectual disability by designing new framework of the features of postural control for the schoolchild with intellectual disability. For this, the study investigated what sensations the schoolchild are using to maintain posture by selectively or synthetically applying vision, vestibular sensation and somato-sensation, and how the coordinative sensory system of the schoolchild is responding to any sway referenced sensory stimulus. The study intended to prove the limitation of motor system in estimating the postural stability by providing the cognitive motor task, and provided the features of postural control of the schoolchild with intellectual disability by measuring the onset times and orders of muscle contraction of neuron-muscle when there is a postural control taking place due to the exterior disturbance. Furthermore, by comparatively analyzing the difference between the normal schoolchild and the intellectually disabled schoolchild, this study provided an optimal direction for treatment planning when the rehabilitation program is applied in the postural control ability training program for the schoolchild with intellectual disability. Taking gender and age into consideration, 52 schoolchild including 26 normal schoolchild and 26 intellectually disabled schoolchild were selected. To measure the features of postural control, CTSIB test, and postural control strategy test were conducted. The result of experiment is as followed. First, the schoolchild with intellectual disability showed different feature in using sensory system to control posture. The normal schoolchild tended to depend on somato-sensory or vision, and showed a stable postural control toward a sway referenced stimulus on somato-sensory system. The schoolchild with intellectual disability tended to use somato-sensory or vision, and showed a very instable postural control toward a sway referenced vision or a sway referenced stimulus on somato-sensory system. In sensory analysis, the schoolchild with intellectual disability showed lower level of proficiency in somato-sensation percentile, vision percentile and vestibular sensation percentile compare to the normal schoolchild. Second, as for the onset times and orders of muscle contraction for strategies of postural control when there is an exterior physical stimulus, the schoolchild with intellectual disability showed a relatively delayed onset time of muscle control, and it was specially greater when the perturbation is from backward. As for the onset orders of muscle contraction, it started from muscles near coax then moved to the muscles near ankle joint, and the numbers and kinds of muscles involved were greater than the normal schoolchild. The normal schoolchild showed a fast muscle contracting reaction from every direction after the perturbation stimulus, and the contraction started from the muscles near the ankle joint and expanded to the muscles near coax. From the results of the experiments, the special feature of the postural control of the schoolchild with intellectual disability is that they have a higher dependence on vision in sensory system, and there was no appropriate integration of swayed sensation observed in upper level of central nerve system. In the motor system, the onset time of muscle contraction for postural control was delayed, and it proceeded in reversed order of the normal schoolchild. Therefore, when use the clinical physical therapy to improve the postural control ability, various sensations should be provided and should train the schoolchild to efficiently use the provided sensations and use the sensory experience recorded in upper level of central nerve system to improve postural control ability. At the same time, a treatment program that can improve the processing ability of central nerve system through meaningful activities with organizing and planning adapting reaction should be provided. Also, a proprioceptive motor control training program that can induce faster muscle contraction reaction and more efficient onset orders from muscularskeletal system is need to be provided as well.

• Journal of Digestive Cancer Research
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• v.1 no.1
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• pp.36-42
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• 2013

Background/Aims: Gemcitabine is regarded as a reference regimen for advanced pancreatic cancer and shows relatively safe toxicity profiles compared with other cytotoxic agents. However, many oncologists are appeared to be still reluctant to treat elderly pancreatic cancer patients with cytotoxic chemotherapy because of predicted low response rate and potential adverse events. Methods: All patients who were received gemcitabine based chemotherapy between 2007 and 2010 were identified and clinical, laboratory, radiographic data were retrospectively reviewed. Patients were divided into two groups based on their ages: less than 65, and equal or more than 65 years old. Gemcitabine, at a dose of 1,000 mg per square meter of body surface area, was administered by intravenously over 30 minutes weekly for 3 weeks followed by 1 week rest, alone or along with other chemotherapeutic agents including cisplatin, capecitabine and erlotinib. Results: A total of 61 patients were identified and all patients were not eligible to receive operation because of advanced stage at diagnosis. Twenty three patients (37.7%) were equal or more than 65 year of age. Mean age was 56 years old and 71 years old in each group. Laboratory data including CA 19-9 were not significantly different. More gemcitabine monotherapy was delivered (56.5% vs. 26.3%, p=0.029) and less second or third line therapy was adminis- tered (17.4% vs. 50.0%, p=0.014) in elderly group. Cholangitis occurred and stent placement were performed similarly in both groups. Conclusion: Gemcitabine based chemotherapy can be administered safely to elderly pancreatic cancer patients and comparable response rate and progression free survival can be expected as young patients.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.165-172
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• 2023

Objectives : The purpose of this study is to determine whether there is a significant difference in the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio according to the history of suicide attempt in patients with psychiatric diseases. Methods : A medical record review was conducted on patients who had been hospitalized in Konyang University Hospital since 2021-03-01 to 2023-02-28 to collect demographic and clinical characteristics. T-test for continuous variables and Chi-square test for categorical variables were performed to determine demographic differences according to the history of suicide attempt, and the ANCOVA test was performed to compare the average value of peripheral inflammatory marker according to the history of suicide attempt with gender and age as covariates. One-way variance analysis was performed to determine whether the number of suicide attempt causes significant difference of the peripheral inflammatory marker. Results : The final analysis target of this study was 266 patients, 101 had history of suicide attempt, and 165 had no history of suicide attempt. The neutrophil-to-lymphocyte ratio (p<0.001) and platelet-to-lymphocyte ratio (p<0.001) were higher in patients with the history of suicide attempt than patients without the history of suicide attempt, but the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were not significantly increased depending on the serial increase of number of suicide attempts. Conclusions : This study suggests that peripheral inflammatory markers are meaningful and easily accessible indicators for predicting the risk of suicide attempt in psychiatric patients. We expect that prospective follow-up study will be conducted with more subjects and controlled potential confounding variables.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.125-133
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• 2023

Objectives : This study aims to compare the mental health of adolescents living in child care institutions (orphanages) and youth shelters, to provide basic data for appropriate psychiatric interventions for each facilities. Methods : The sample consisted of 157 adolescents in child care institutions and 31 adolescents in Youth Shelters who completed the Korean version of the Youth Self Report (K-YSR). We compared the K-YSR scores between the two groups and also examined factors related to suicidality. Results : Adolescents in youth shelters were older and had higher rates of drinking (p<0.001), smoking (p<0.001), and "abnormal sleep" (p=0.007) than adolescents in child care institutions. They also showed higher 'suicidality' (p=0.004) and K-YSR scores. On the other hand, adolescents in child care institutions have lower 'suicidality', but they have higher 'suicidality' when they have 'abnormal sleep' (OR 4.194; p=0.006), 'abnormal diet' (OR 2.503; p=0.010), and 'concerns about weight gain' (OR 2.503; p=0.010). Additionally, 17.6% of participants in the study showed 'suicidality'. The 'suicidality' group had a higher overall K-YSR score than the non-suicidal group, and had higher 'abnormal sleep' (OR 3.766; p=0.014) and 'concern about weight gain' (OR 2.864; p=0.032). Conclusions : Adolescents in youth shelters appear to have more serious clinical difficulties than adolescents in child care institutions, so prompt psychiatric intervention is needed. Additionally, it is necessary to consider mental health assessments including suicidality when adolescents in child care institutions complain of sleep, eating, or weight gain problems.

• Journal of Life Science
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• v.33 no.11
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• pp.905-914
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• 2023

To evaluate the effectiveness of the skin barrier improvement of lactic acid (LA) and gluconolactone (GL), the expression of filaggrin, loricrin, hyaluronic acid (HA), hyaluronan syhthase-2 (HAS2), and aquaporine-3 (AQP3) in keratinocytes, and the moisture content and transepidermal water loss (TEWL) by clinical trials were evaluated. The expression levels of filaggrin and locricrin, which are the main factors affecting the proper functioning of skin barrier function, and HA, HAS2, and AQP3, which are skin moisturizing-related proteins measured by quantitative real-time polymerase chain reaction (qRT-PCR) and western blotting. The results showed that the expression levels of the factors that decreased by H2O2 treatment were significantly increased by LA, GL, and a mixture of LA and GL at the mRNA and protein levels (p<0.05). The nanoemulsion containing a mixture of LA and GL was prepared using the emulsion inversion method, and the average particle size was 299.9 ± 0.287 nm. After measuring the TEWL of nanoemulsion using Vapometer, it was found that TEWL significantly decreased by 15.53% and 26.73% after two weeks and four weeks of product use, respectively, compared to TEWL before product use (p<0.001). Similarly, the skin moisture content of the nanoemulsion significantly increased by 15.40% and 26.59% after two weeks and four weeks of product use, respectively, compared to skin moisture content before product use (p<0.001). Therefore, the skin barrier function and moisturizing effect of a mixture of LA and GL are shown by increasing the moisture content and decreasing the TEWL by increasing the expression of filaggrin, loricrin, HA, HAS2, and AQP3. This suggests the possibility for the development of functional cosmetic ingredients in the future.

• The Journal of Korean Academy of Sensory Integration
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• v.21 no.2
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• pp.69-83
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• 2023

Objective : This study sought to systematically examine the intervention effect of social stories when applied in relation to children with sleep disorders. Methods : Studies available in the SCOPUS, ScienceDirect, PsycArticles, and PubMed databases that were published from 2001 to 2022 were searched. The keywords used for the search were as follows: ("social story" OR "social stories") AND ("sleep" OR "sleep disorders" OR "sleep wake disorder bedtimes" OR "sleep initiation and maintenance disorders" OR "sleep wake disorder" OR "sleep arousal disorders"). Based on the selection criteria, six experimental studies were selected and analyzed. Results : The selected studies were two randomized controlled trials, three individual trials, and one case study. The subjects were mostly children diagnosed with autism spectrum disorder who were school-aged or adolescent. The intervention types were often complex interventions, including social stories and other interventions, while the durations of the interventions varied from one day to more than 40 days. The interventions had a positive effect on the subjects' sleep quality, with night wakings, sleep onset delay, and sleep anxiety all being improved. As standardized assessment tools to evaluate the effectiveness of social stories, the Child Sleep Habits Questionnaire and the Child Behavior Checklist were used in two papers each, and were the most commonly used. As non-standardized assessment tools, each of the four papers used turbulence and sleep diaries as assessment tools. Conclusion : The effect of social story mediation can be divided into sleep quality and sleep-related behavior. In terms of sleep quality, studies showing improvements in night wakings, sleep onset delay, and sleep anxiety accounted for a large proportion of the sample. The detailed effect area of sleep quality showed a significant improvement after the interventions in most studies, and in all six studies analyzed in the present study, the continuation of the effect after the intervention was confirmed via follow-up tests. Thus, the findings of this study are expected to be helpful when applying social stories in children with sleep disorders in clinical practice due to presenting the intervention effects, outcome evaluation tools, and intervention periods in children with sleep disorders in prior investigations involving social stories.