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Pelvic floor muscle exercise with biofeedback helps regain urinary continence after robot-assisted radical prostatectomy

  • Kim, Yeong Uk;Lee, Dong Gyu;Ko, Young Hwii
    • Journal of Yeungnam Medical Science
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    • v.38 no.1
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    • pp.39-46
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    • 2021
  • Background: To determine the benefit of pelvic floor muscle exercise (PFME) with visual biofeedback on promoting patient recovery from incontinence, we investigated variables associated with the early restoration of continence for patients who underwent robot-assisted radical prostatectomy (RARP). Methods: Of the 83 patients enrolled, 41 consecutive patients completed PFME (the exercise group), and the other 42 consecutive patients just before the PFME program commenced (the control group). The primary outcome was whether PFME engagement was associated with zero pad continence restoration within 3 months of surgery. Results: Continence restoration percentages (defined as zero pads used per day) at 1, 3, and 6 months after surgery were 49.4%, 77.1%, and 94.0%, respectively. The exercise group achieved significantly higher recovery rates at 1 month (p=0.037), 3 months (p<0.001), and 6 months (p=023). Cox regression analysis demonstrated that a lower Gleason score (<8; hazard ratio [HR], 2.167), lower prostate specific antigen (<20 ng/dL; HR, 2.909), and engagement in PFME (HR, 3.731) were independent predictors of early recovery from postprostatectomy incontinence. Stratification by age showed that those younger than 65 years did not benefit significantly from exercise (log-rank test, p=0.08), but that their elderly counterparts, aged 65-70 years (p=0.007) and >70 years old (p=0.002) benefited significantly. Conclusion: This study suggests that postoperative engagement in PFME with biofeedback speeds up the recovery of continence in elderly patients (≥65 years old) that undergo RARP.

Ginsenoside Rg3 reduces the adhesion, invasion, and intracellular survival of Salmonella enterica serovar Typhimurium

  • Mechesso, Abraham F.;Quah, Yixian;Park, Seung-Chun
    • Journal of Ginseng Research
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    • v.45 no.1
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    • pp.75-85
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    • 2021
  • Background: Invasive infections due to foodborne pathogens, including Salmonella enterica serovar Typhimurium, are prevalent and life-threatening. This study aimed to evaluate the effects of ginsenoside Rg3 (Rg3) on the adhesion, invasion, and intracellular survival of S. Typhimurium. Methods: The impacts of Rg3 on bacterial growth and host cell viability were determined using the time kill and the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide assays, respectively. Gentamicin assay and confocal microscopic examination were undertaken to determine the effects of Rg3 on the adhesive and invasive abilities of S. Typhimurium to Caco-2 and RAW 264.7 cells. Quantitative reverse transcription polymerase chain reaction was performed to assess the expression of genes correlated with the adhesion, invasion, and virulence of S. Typhimurium. Results: Subinhibitory concentrations of Rg3 significantly reduced (p < 0.05) the adhesion, invasion, and intracellular survival of S. Typhimurium. Rg3 considerably reduced (p < 0.05) the bacterial motility as well as the release of nitrite from infected macrophages in a concentration-dependent manner. The expression of genes related to the adhesion, invasion, quorum sensing, and virulence of S. Typhimurium including cheY, hilA, OmpD, PrgK, rsgE, SdiA, and SipB was significantly reduced after Rg3 treatment. Besides, the compound downregulated rac-1 and Cdc-42 that are essential for actin remodeling and membrane ruffling, thereby facilitating Salmonella entry into host cells. This report is the first to describe the effects of Rg3 on "trigger" entry mechanism and intracellular survival S. Typhimurium. Conclusion: Rg3 could be considered as a supplement agent to prevent S. Typhimurium infection.

The relationship between smartphone addiction and musculoskeletal pain prevalence among young population: a cross-sectional study

  • Mustafaoglu, Rustem;Yasaci, Zeynal;Zirek, Emrah;Griffiths, Mark D.;Ozdincler, Arzu Razak
    • The Korean Journal of Pain
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    • v.34 no.1
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    • pp.72-81
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    • 2021
  • Background: In the literature, there have been debates as to whether smartphone use has negative effects on physical and mental health. The present study investigated the extent to which smartphone addiction impacts on musculoskeletal pain prevalence among university students. Methods: The questionnaire consisted of three sections: demographic information, the Smartphone Addiction Scale (SAS), and the modified Nordic Musculoskeletal Questionnaire. Results: A total of 249 participants were included in this cross-sectional study. The body parts that were reported with highest prevalence of musculoskeletal pain were the upper back (70.3%), neck (65.9%), and wrists/hands (68.7%). The SAS scores were correlated with duration of smartphone use on a typical day (P = 0.001), duration of owning a smartphone (P = 0.027), and musculoskeletal pain prevalence in the neck (P = 0.001), wrists/hands (P = 0.001), shoulders (P = 0.025), and upper back (P = 0.023). The SAS score was significantly associated with prevalence of musculoskeletal pain in the neck (odd ratio [OR], 1.08; 95% confidence interval [CI], 0.98-1.10; P = 0.002), wrists/hands (OR, 1.07; 95% CI, 0.97-1.09; P = 0.001), and upper back (OR, 1.10; 95% CI, 0.98-1.11; P = 0.033). Conclusions: The findings indicated that the upper back, neck, and wrists/hands have a higher prevalence of musculoskeletal pain among smartphone users, particularly those with a smartphone addiction. Smartphone addiction scores were correlated with duration of smartphone use on a typical day, duration of owning smartphone, and musculoskeletal pain prevalence in the neck, wrists/hands, shoulders, and upper back.

Multi-condition optimization and experimental verification of impeller for a marine centrifugal pump

  • Wang, Kai;Luo, Guangzhao;Li, Yu;Xia, Ruichao;Liu, Houlin
    • International Journal of Naval Architecture and Ocean Engineering
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    • v.12 no.1
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    • pp.71-84
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    • 2020
  • In order to improve the performance of marine centrifugal pump, a centrifugal pump whose specific speed is 66.7 was selected for the research. Outlet diameter D2, outlet width b2, blade outlet angle β2, blade wrap φ and blade number z of the impeller were chosen as the variables. The maximum weighted average efficiency and the minimum vibration intensity at the base were calculated as objectives. Based on the Latin Hypercube method, the impeller was numerically optimized. The numerical results show that after optimization, the amplitudes of pressure fluctuation on the main frequency at different monitoring points decrease in varying degrees. The radial force on impeller decreases obviously under off-design flow rates and is more symmetrical during the operation of the pump. The variation of the axial force is relatively small, which has no obvious relationship with the rotating angle of the impeller. The energy performance and vibration experiment was performed for verifying. The test results show that the weighted average efficiency under 0.8Qd, 1.0Qd and 1.2Qd increases by 4.3% after optimization. The maximal vibration intensity at M1-M4 on the pump base reduced from 0.36 mm/s to 0.25 mm/s, decreasing by 30.5%. In addition, the vibration velocities of bracket in pump side and outlet flange also have significant reductions.

Numerical investigation on the effect of baffles on liquid sloshing in 3D rectangular tanks based on nonlinear boundary element method

  • Guan, Yanmin;Yang, Caihong;Chen, Ping;Zhou, Li
    • International Journal of Naval Architecture and Ocean Engineering
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    • v.12 no.1
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    • pp.399-413
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    • 2020
  • The numerical simulation of liquid sloshing in the three-dimensional tanks under horizontal excitation and roll excitation was carried out, and the inhibition effect of different baffles on the sloshing phenomenon was investigated. The numerical calculations were carried out by the nonlinear Boundary Element Method (BEM) with Green's theorem based on the potential flow, which was conducted with the governing equation corresponding to the boundaries of each region. The validity of the method was verified by comparing with experimental values and published literatures. The horizontal baffle, the vertical baffle and the T-shaped baffle in the sloshing tanks were investigated respectively, and the baffles' position, dimension and the liquid depth were provided and discussed in detail. It is drawn that the baffle shape plays a non-negligible role in the tank sloshing. The vertical baffle is a more effective way to reduce the sloshing amplitude when the tank is under a horizontal harmonic excitation while the horizontal baffle is a more effective way when the tank is under a roll excitation. The amplitude of free surface elevation at right tank wall decreases with the increasing of the horizontal baffle length and the vertical baffle height. Although the T-shaped baffle has the best suppression effect on tank sloshing under horizontal excitation, it has limited suppression effect under roll excitation and will complicate the sloshing phenomenon when changing baffle height.

Fecal Calprotectin and Phenotype Severity in Patients with Cystic Fibrosis: A Systematic Review and Meta-Analysis

  • Talebi, Saeedeh;Day, Andrew S.;Rezaiyan, Majid Khadem;Ranjbar, Golnaz;Zarei, Mitra;Safarian, Mahammad;Kianifar, Hamid Reza
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.1
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    • pp.1-12
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    • 2022
  • Inflammation plays an important role in the outcome of patients with cystic fibrosis (CF). It may develop due to cystic fibrosis transmembrane conductance regulator protein dysfunction, pancreatic insufficiency, or prolonged pulmonary infection. Fecal calprotectin (FC) has been used as a noninvasive method to detect inflammation. Therefore, the aim of the current meta-analysis was to investigate the relationship between FC and phenotype severity in patients with CF. In this study, searches were conducted in PubMed, Science Direct, Scopus, and Embase databases up to August 2021 using terms such as "cystic fibrosis," "intestine," "calprotectin," and "inflammation." Only articles published in English and human studies were selected. The primary outcome was the level of FC in patients with CF. The secondary outcome was the relationship between FC and clinical severity. Statistical analysis was performed using Comprehensive Meta-Analysis software. Of the initial 303 references, only six articles met the inclusion criteria. The mean (95% confidence interval [CI]) level of FC was 256.5 mg/dL (114.1-398.9). FC levels were significantly associated with pancreatic insufficiency (mean, 243.02; 95% CI, 74.3 to 411.6; p=0.005; I2=0), pulmonary function (r=-0.39; 95% CI, -0.58 to -0.15; p=0.002; I2=60%), body mass index (r=-0.514; 95% CI, 0.26 to 0.69; p<0.001; I2=0%), and Pseudomonas colonization (mean, 174.77; 95% CI, 12.5 to 337.02; p=0.035; I2=71%). While FC is a reliable noninvasive marker for detecting gastrointestinal inflammation, it is also correlated with the severity of the disease in patients with CF.

Factors Affecting Depression of Korean Physicians (한국 의사들의 우울과 이에 영향을 미치는 요인 분석)

  • Lee, Suh Eun;Shin, Yeju;Kim, Hyoungjun;Lee, Mi Yeon;Jung, Sra;Shin, Dong Won;Cho, Sung Joon
    • Korean Journal of Biological Psychiatry
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    • v.29 no.2
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    • pp.40-45
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    • 2022
  • Objectives This study aims to assess the status quo of depression among Korean physicians and identify stressors and psychiatric assets related to it. Methods The questionnaire was designed to assess depression, stressors, burnout and psychiatric assets. 343 physicians were included in the analyses. Results Physician depression in Korea was found to be related to several daily life stressors and occupational stressors. It was also related to higher burnout and lower psychological assets. Physicians who reported workplace problems, familial problems, and mannerism were at higher risk of depression while who reported passion (in psychiatric assets) were at lower risk of depression. Conclusions This study identified factors affecting physician depression in Korea. Further research would benefit physicians and their patients by identifying and testing various, including personal and organizational, intervention methods.

Functional Characterization of Drosophila melanogaster CYP6A8 Fatty Acid Hydroxylase

  • Sang-A Lee;Vitchan Kim;Byoungyun Choi;Hyein Lee;Young-Jin Chun;Kyoung Sang Cho;Donghak Kim
    • Biomolecules & Therapeutics
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    • v.31 no.1
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    • pp.82-88
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    • 2023
  • Genomic analysis indicated that the genome of Drosophila melanogaster contains more than 80 cytochrome P450 genes. To date, the enzymatic activity of these P450s has not been extensively studied. Here, the biochemical properties of CYP6A8 were characterized. CYP6A8 was cloned into the pCW vector, and its recombinant enzyme was expressed in Escherichia coli and purified using Ni2+-nitrilotriacetate affinity chromatography. Its expression level was approximately 130 nmol per liter of culture. Purified CYP6A8 exhibited a low-spin state in the absolute spectra of the ferric forms. Binding titration analysis indicated that lauric acid and capric acid produced type I spectral changes, with Kd values 28 ± 4 and 144 ± 20 µM, respectively. Ultra-performance liquid chromatography-mass spectrometry analysis showed that the oxidation reaction of lauric acid produced (ω-1)-hydroxylated lauric acid as a major product and ω-hydroxy-lauric acid as a minor product. Steady-state kinetic analysis of lauric acid hydroxylation yielded a kcat value of 0.038 ± 0.002 min-1 and a Km value of 10 ± 2 µM. In addition, capric acid hydroxylation of CYP6A8 yielded kinetic parameters with a kcat value of 0.135 ± 0.007 min-1 and a Km value of 21 ± 4 µM. Because of the importance of various lipids as carbon sources, the metabolic analysis of fatty acids using CYP6A8 in this study can provide an understanding of the biochemical roles of P450 enzymes in many insects, including Drosophila melanogaster.

Chylous Ascites After Gastric Cancer Surgery: Risk Factors and Treatment Results

  • Sung Hyun Park;Ki-Yoon Kim;Minah Cho;Hyoung-Il Kim;Woo Jin Hyung;Yoo Min Kim
    • Journal of Gastric Cancer
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    • v.23 no.2
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    • pp.253-263
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    • 2023
  • Purpose: Although chylous ascites is a frequent complication of radical gastrectomy for gastric cancer, proper diagnostic criteria and optimal treatment strategies have not been established. This study aimed to identify the clinical features of chylous ascites and evaluate the treatment outcomes. Materials and Methods: We retrospectively analyzed the data of patients who underwent radical gastrectomy between 2013 and 2019. Diagnosis was made when milky fluid or elevated triglyceride levels (≥100 mg/dL) appeared in the drains without a preceding infection. The clinical features, risk factors, and treatment outcomes were assessed according to the initial treatment modalities for fasting and non-fasting groups. Results: Among the 7,388 patients who underwent radical gastrectomy for gastric cancer, 156 (2.1%) experienced chylous ascites. The median length of hospital stay was longer in patients with chylous ascites than in those without (median [interquartile range]: 8.0 [6.0-12.0] vs. 6.0 [5.0-8.0], P<0.001). Low body mass index (adjusted odds ratio [aOR]=0.9; P<0.001), advanced gastric cancer (aOR=1.51, P=0.024), open surgery (reference: laparoscopic surgery; aOR=1.87, P=0.003), and extent of surgical resection (reference: subtotal gastrectomy, total gastrectomy, aOR=1.5, P=0.029; proximal gastrectomy, aOR=2.93, P=0.002) were associated with the occurrence of chylous ascites. The fasting group (n=12) was hospitalized for a longer period than the non-fasting group (n=144) (15.0 [12.5-19.5] vs. 8.0 [6.0-10.0], P<0.001). There was no difference in grade III complication rate (16.7% vs. 4.2%, P=0.117) or readmission rate (16.7% vs. 11.1%, P=0.632) between the groups. Conclusions: A fat-controlled diet and medication without fasting provided adequate initial treatment for chylous ascites after radical gastrectomy for gastric cancer.

Development and evaluation of a mobile app-based musculoskeletal exercise program for operating room nurses (수술실 간호사를 위한 앱 기반 근골격계 운동프로그램의 개발 및 효과검증)

  • Hwawon Nam;Sangeun Jun
    • Journal of Korean Biological Nursing Science
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    • v.25 no.3
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    • pp.215-227
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    • 2023
  • Purpose: The aim of this study was to develop a mobile app-based musculoskeletal exercise program (AMSEP) for operating room (OR) nurses and evaluate its effects on self-efficacy, the flexibility of the shoulders, lower back, and legs, and musculoskeletal symptoms and fatigue. Methods: The AMSEP was developed based on the information-motivation-behavioral skill model. In total, 48 OR nurses were recruited at a university hospital in Korea and divided into an experimental group (n=24) and a control group (n=24), matched for career experience in the OR. The experimental group participated in the AMSEP, while the control group received a booklet regarding musculoskeletal exercise. Results: The experimental group showed significant increases in self-efficacy (t = -2.77, p = .008) and flexibility of the right shoulder (t = -4.08, p < .001), left shoulder (t = -3.28, p = .002), lower back (t = -3.75, p < .001), and legs (t = -3.96, p < .001) compared to the control group. Musculoskeletal symptoms (t = 2.75, p = .008), and fatigue (Z = -1.98, p = .048) significantly decreased in the experimental group compared to the control group. Conclusion: Our findings indicate that the AMSEP for OR nurses provided information on the prevention of musculoskeletal disorders and methods of exercise, as well as an opportunity for continued exercise performance through self-management. The AMSEP was easily accessible and effective in increasing self-efficacy and flexibility and reducing musculoskeletal symptoms and fatigue.