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The Influence of Eye Movement Program Applied to Elderly People on Static Balance (안구운동 프로그램 적용이 노인의 정적 균형에 미치는 영향)

  • Park, Jong-Hang;Kang, Bo-Ram;Kim, Yoon-Hwan;Kim, Jang-Ju;Son, Kyung-Hyun;Song, Hyun-Seung;Kim, Tae-Won
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.17 no.2
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    • pp.11-17
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    • 2011
  • Background: To evaluate the influences of Eye movement program applied to elderly people on static balance. Methods: The subjects consisted of fourteen elderly people. The subjects were divided into two group. The control group (n=7) received no exercise and/or stimulation. The Eye movement program training (E/P) group (n=7) performed balance training using word card and batom. E/P group were accomplished during 4weeks (5 day/week, 60 min/day). All tests were completed before and after experiment. The static balance ability was measured by normal standing when eye open and close on good balance system, respectively. For each case, the experimental data were obtained in 3 item; mean X speed, mean Y speed and velocity moment. Results: The result of this study were as follows: 1. In E/P group, the statistically significants were shown on only mean Y speed in the case of normal standing when eye open (p<.05), but the statistically significants were not shown on mean X, Y speed and velocity moment in the case of normal standing when eye close (p>.05). 2. In control group, the statistically significants were not shown on all posture (p>.05). 3. There was a statistically significant difference on the mean Y speed and velocity moment in the case of normal standing when eye open between control group and E/P group (p<.05). Conclusions: The above results revealed that balance training using Eye movement program were partly effective for improving the static balance ability.

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Effects of the cathepsin K inhibitor with mineral trioxide aggregate cements on osteoclastic activity

  • Kim, Hee-Sun;Kim, Soojung;Ko, Hyunjung;Song, Minju;Kim, Miri
    • Restorative Dentistry and Endodontics
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    • v.44 no.2
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    • pp.17.1-17.10
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    • 2019
  • Objectives: Root resorption is an unexpected complication after replantation procedures. Combining anti-osteoclastic medicaments with retrograde root filling materials may avert this resorptive activity. The purpose of this study was to assess effects of a cathepsin K inhibitor with calcium silicate-based cements on osteoclastic activity. Methods: MC3T3-E1 cells were cultured for biocompatibility analyses. RAW 264.7 cells were cultured in the presence of the receptor activator of nuclear factor-kappa B and lipopolysaccharide, followed by treatment with Biodentine (BIOD) or ProRoot MTA with or without medicaments (Odanacatib [ODN], a cathepsin inhibitor and alendronate, a bisphosphonate). After drug treatment, the cell counting kit-8 assay and Alizarin red staining were performed to evaluate biocompatibility in MC3T3-E1 cells. Reverse-transcription polymerase chain reaction, tartrate-resistant acid phosphatase (TRAP) staining and enzyme-linked immunosorbent assays were performed in RAW 264.7 cells to determine the expression levels of inflammatory cytokines, interleukin $(IL)-1{\beta}$, IL-6, tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$) and prostaglandin E2 (PGE2). Data were analyzed by one-way analysis of variance and Tukey's post hoc test (p < 0.05). Results: Biocompatibility results showed that there were no significant differences among any of the groups. RAW 264.7 cells treated with BIOD and ODN showed the lowest levels of $TNF-{\alpha}$ and PGE2. Treatments with BIOD + ODN were more potent suppressors of inflammatory cytokine expression (p < 0.05). Conclusion: The cathepsin K inhibitor with calcium silicate-based cement inhibits osteoclastic activity. This may have clinical application in preventing inflammatory root resorption in replanted teeth.

Comparison of Clinical Characteristics and Polysomnographic Findings between REM Sleep Behavior Disorder with and without Associated Central Nervous System Disorders (중추신경계질환 동반 여부에 따른 렘수면 행동장애의 임상 특성과 수면다원기록소견 소견 비교)

  • Lee, Yu-Jin;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.58-63
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    • 2005
  • Objectives: REM sleep behavior disorder (RBD), characterized by excessive motor activity during REM sleep, is associated with loss of muscle atonia. In recent years, it has been reported that RBD has high co-morbidity with CNS disorders (especially, Parkinson's disease, dementia, multiple system atrophy, etc.). We aimed to assess differences in clinical and polysomnographic findings among RBD patients, depending on the presence or absence of central nervous system (CNS) disorders. Methods: The medical records and polysomnographic data of 81 patients who had been diagnosed as having RBD were reviewed. The patients were classified into two groups: associated RBD (aRBD, i.e., with a clinical history and/or brain MRI evidence of CNS disorder) and idiopathic RBD (iRBD, i.e., without a clinical history and/or brain MRI evidence of CNS disorder) groups. Twenty-one patients (25.9%) belonged to the aRBD group and 60 patients (74.1%) belonged to the iRBD group. The clinical characteristics and polysomnographic findings of the two groups were compared. Results: Periodic limb movement disorder (PLMD), i.e., PLMI (periodic limb movement index)>5, was observed more frequently in the aRBD group than in the iRBD group (p<0.001, Fisher's exact test). Also, obstructive sleep apnea syndrome (OSAS), i.e., RDI (respiratory disturbance index)>5, was found more frequently in the aRBD group (p=0.0042, Fisher's exact test). The percentages for slow wave sleep and sleep efficiency were significantly lower in the aRBD group than in the iRBD group. Conclusion: We found that 1 out of 4 RBD patients had associated CNS disorders, warranting more careful neurological evaluation and follow-up in this category of RBD. In this category of RBD patients, we also found more frequent PLMD and OSAS. These patients were also found to have lower slow wave sleep and sleep efficiency. In summary, RBD patients with associated CNS disorders suffer from more disturbed sleep than those without them.

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The Relationship between the Progression of Chronic Kidney Disease and Beta Cell Function in Non-Diabetic Korean Adults (대한민국 비당뇨 성인에서 만성신장질환과 인슐린저항성 및 베타세포기능의 관련성)

  • Kim, Hyung Rag
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.3
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    • pp.165-171
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    • 2020
  • This study examined the relationship between chronic kidney disease (CKD) and the homeostasis model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-B) in non-diabetic Korean adults. This study included 4,380 adults aged 20 or older (50.32±16.14) using the 2015 Korea National Health and Nutrition Examination Survey (KNHANES) data, which represents the national data in Korea. The present study had several key findings. First, in terms of HOMA-IR, after adjusting for the related variables (Model 4), the HOMA-IR (M±SE, 95% confidence interval [CI]) in group 1 (G1; estimated glomerular filtration rate [eGFR], ≥90 mL/min/1.73 ㎡), group 2 (G2; eGFR, 60~89 mL/min/1.73 ㎡), group 3a (G3a; eGFR, 30~59 mL/min/1.73 ㎡), and ≥group 3b (≥G3b; eGFR, <30 mL/min/1.73 ㎡) were 1.78±0.03 (1.73~1.83), 1.87±0.03 (1.81~1.93), 2.16±0.13 (1.91~2.42), and 2.59±0.24 (2.12~3.06), respectively. The HOMA-IR was positively associated with the progression of CKD (P<0.001). Second, in terms of the HOMA-B, after adjusting for the related variables (Model 4), the HOMA-B (M±SE, 95% CI) in G1, G2, G3a, and ≥G3b were 87.46±1.21 (85.08~89.84), 89.11±1.38 (86.40~91.81), 104.82±5.91 (93.23~116.42), and 123.97±10.87 (102.66~145.29), respectively. HOMA-B was positively associated with the progression of CKD (P<0.001). Both insulin resistance and the beta-cell function were positively associated with CKD in non-diabetic Korean adults.

Clinical applications and performance of intelligent systems in dental and maxillofacial radiology: A review

  • Nagi, Ravleen;Aravinda, Konidena;Rakesh, N;Gupta, Rajesh;Pal, Ajay;Mann, Amrit Kaur
    • Imaging Science in Dentistry
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    • v.50 no.2
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    • pp.81-92
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    • 2020
  • Intelligent systems(i.e., artificial intelligence), particularly deep learning, are machines able to mimic the cognitive functions of humans to perform tasks of problem-solving and learning. This field deals with computational models that can think and act intelligently, like the human brain, and construct algorithms that can learn from data to make predictions. Artificial intelligence is becoming important in radiology due to its ability to detect abnormalities in radiographic images that are unnoticed by the naked human eye. These systems have reduced radiologists' workload by rapidly recording and presenting data, and thereby monitoring the treatment response with a reduced risk of cognitive bias. Intelligent systems have an important role to play and could be used by dentists as an adjunct to other imaging modalities in making appropriate diagnoses and treatment plans. In the field of maxillofacial radiology, these systems have shown promise for the interpretation of complex images, accurate localization of landmarks, characterization of bone architecture, estimation of oral cancer risk, and the assessment of metastatic lymph nodes, periapical pathologies, and maxillary sinus pathologies. This review discusses the clinical applications and scope of intelligent systems such as machine learning, artificial intelligence, and deep learning programs in maxillofacial imaging.

Pathogenic variant in NLRP7 (19q13.42) associated with recurrent gestational trophoblastic disease: Data from early embryo development observed during in vitro fertilization

  • Sills, E. Scott;Obregon-Tito, Alexandra J.;Gao, Harry;McWilliams, Thomas K.;Gordon, Anthony T.;Adams, Catharine A.;Slim, Rima
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.1
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    • pp.40-46
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    • 2017
  • Objective: To describe in vitro development of human embryos derived from an individual with a homozygous pathogenic variant in NLRP7 (19q13.42) and recurrent hydatidiform mole (HM), an autosomal recessive condition thought to occur secondary to an oocyte defect. Methods: A patient with five consecutive HM pregnancies was genomically evaluated via next generation sequencing followed by controlled ovarian hyperstimulation, in vitro fertilization (IVF) with intracytoplasmic sperm injection, embryo culture, and preimplantation genetic screening. Findings in NLRP7 were recorded and embryo culture and biopsy data were tabulated as a function of parental origin for any identified ploidy error. Results: The patient was found to have a pathogenic variant in NLRP7 (c.2810+2T>G) in a homozygous state. Fifteen oocytes were retrieved and 10 embryos were available after fertilization via intracytoplasmic sperm injection. Developmental arrest was noted for all 10 embryos after 144 hours in culture, thus no transfer was possible. These non-viable embryos were evaluated by karyomapping and all were diploid biparental; two were euploid and eight had various aneuploidies all of maternal origin. Conclusion: This is the first report of early human embryo development from a patient with any NLRP7 mutation. The pathogenic variant identified here resulted in global developmental arrest at or before blastocyst stage. Standard IVF should therefore be discouraged for such patients, who instead need to consider oocyte (or embryo) donation with IVF as preferred clinical methods to treat infertility.

Risk Factors for Duodenal Stump Leakage after Laparoscopic Gastrectomy for Gastric Cancer

  • Gu, Lihu;Zhang, Kang;Shen, Zefeng;Wang, Xianfa;Zhu, Hepan;Pan, Junhai;Zhong, Xin;Khadaroo, Parikshit Asutosh;Chen, Ping
    • Journal of Gastric Cancer
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    • v.20 no.1
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    • pp.81-94
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    • 2020
  • Purpose: Duodenal stump leakage (DSL) is a potentially fatal complication that can occur after gastrectomy, but its underlying risk factors are unclear. This study aimed to investigate the risk factors and management of DSL after laparoscopic radical gastrectomy for gastric cancer (GC). Materials and Methods: Relevant data were collected from several prospective databases to retrospectively analyze the data of GC patients who underwent Billroth II (B-II) or Rouxen-Y (R-Y) reconstruction after laparoscopic gastrectomy from 2 institutions (Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, and HwaMei Hospital, University of Chinese Academy of Sciences). The DSL risk factors were analyzed using univariate and multivariate analysis regression. Results: A total of 810 patients were eligible for our analysis (426 with R-Y, 384 with B-II with Braun). Eleven patients had DSL (1.36%). Body mass index (BMI), elevated preoperative C-reactive protein (CRP) level, and unreinforced duodenal stump were the independent risk factors for DSL. DSL was diagnosed in 2-12 days, with a median of 8 days. Seven patients received conservative treatment, 3 patients received puncture treatment, and only 1 patient required reoperation. All patients recovered successfully after treatment. Conclusions: The risk factors of DSL were BMI ≥24 kg/㎡, elevated preoperative CRP level, and unreinforced duodenal stump. Nonsurgical treatments for DSL are preferred.

Mitochondria Hypothesis on the Obesity-Prone Tendency in Tae-Eum People (태음인의 비만경향에 대한 미토콘드리아 가설)

  • Shim, Eun-Bo;Lee, Si-Woo;Kim, Sung-Joon;Leem, Chae-Hun;Kwon, Young-Kyu;Baik, You-Sang;Kim, Jong-Yeol;Earm, Yung-E.
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.6
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    • pp.1241-1246
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    • 2009
  • It has been suggested that Tae-Eum peoples are prone to obesity. Although extensive clinical observations have shown this tendency in Sasang Constitutional Medicine (SCM), no scientific hypothesis has been proposed to delineate its mechanism. According to SCM theory, Tae-Eum peoples have a hypoactive lung system and a hyperactive liver system. In this paper we propose a new hypothesis explaining the tendency of obesity in Tae-Eum people in the viewpoint of cell physiology. The hypoactive lung system might imply an attenuated 'respiration' at the cell/subcell level, namely mitochondrial oxygen consumption. Because a functional weakness in mitochondria energy metabolism indicates intrinsic hypo-activity in the consumption (or production) of metabolic energy, we deduced that the tendency can easily induce body weight gain via an increase in anabolism. This relation is also introduced in the graph of cellular metabolic power against body weight. To test this hypothesis, we analyzed the clinical data with 863 subjects. Statistical analysis of the data showed that Tae-Eum peoples had relatively a lower cellular metabolic power, and that the percentage of peoples with BMI>25 was significantly higher than that of the other constitutional types.

Impact of Esophagojejunal Reconstruction without Division of the Mesentery for Total Laparoscopic Total Gastrectomy

  • Ko, Chang Seok;Jheong, Jin Ho;Lee, In-Seob;Kim, Beom Su;Kim, Min-Ju;Yoo, Moon-Won
    • Journal of Gastric Cancer
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    • v.21 no.1
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    • pp.63-73
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    • 2021
  • Purpose: This study aimed to compare the surgical outcomes of total laparoscopic total gastrectomy without mesentery division (LTG without MD) and conventional total laparoscopic total gastrectomy (CLTG), as well as evaluate the appropriate method for esophagojejunostomy (EJ) reconstruction after total laparoscopic total gastrectomy (TLTG). Materials and Methods: We retrospectively analyzed data from 301 consecutive patients who underwent TLTG for upper or middle third gastric cancer between January 2016 and May 2019. After propensity score matching, 95 patients who underwent LTG without MD and 95 who underwent CLTG were assessed. Data on clinical characteristics and surgical outcomes, including operation time, length of postoperative hospital stay, pathological findings, and postoperative complications were analyzed. Results: The LTG without MD group showed a shorter time to first flatus (3.26±0.80 vs. 3.62±0.81 days, P=0.003) and a shorter time to soft diet (2.80±2.09 vs. 3.52±2.20 days, P=0.002). The total EJ-related complications in the LTG without MD group were comparable to those in the CLTG group (9.47% vs. 3.16%, P=0.083). EJ-related leakage (6.32% vs. 3.16%, P=0.317) and EJ-related stricture (3.16% vs. 1.05%, P=0.317) rates were not significantly different between the LTG without MD and CLTG groups. No significant differences were found between the two groups in terms of other early surgical outcomes such as early complications, late complications, hospital stay, and readmission rate. Conclusions: LTG without MD is a safe surgical treatment for upper or middle third gastric cancer. LTG without MD may be an alternative procedure for EJ anastomosis during TLTG.

Safe Discharge Criteria After Curative Gastrectomy for Gastric Cancer

  • Guner, Ali;Kim, Ki Yoon;Park, Sung Hyun;Cho, Minah;Kim, Yoo Min;Hyung, Woo Jin;Kim, Hyoung-Il
    • Journal of Gastric Cancer
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    • v.22 no.4
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    • pp.395-407
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    • 2022
  • Purpose: This study aimed to investigate the relationship between clinical and laboratory parameters and complication status to predict which patients can be safely discharged from the hospital on the third postoperative day (POD). Materials and Methods: Data from a prospectively maintained database of 2,110 consecutive patients with gastric adenocarcinoma who underwent curative surgery were reviewed. The third POD vital signs, laboratory data, and details of the course after surgery were collected. Patients with grade II or higher complications after the third POD were considered unsuitable for early discharge. The performance metrics were calculated for all algorithm parameters. The proposed algorithm was tested using a validation dataset of consecutive patients from the same center. Results: Of 1,438 patients in the study cohort, 142 (9.9%) were considered unsuitable for early discharge. C-reactive protein level, body temperature, pulse rate, and neutrophil count had good performance metrics and were determined to be independent prognostic factors. An algorithm consisting of these 4 parameters had a negative predictive value (NPV) of 95.9% (95% confidence interval [CI], 94.2-97.3), sensitivity of 80.3% (95% CI, 72.8-86.5), and specificity of 51.1% (95% CI, 48.3-53.8). Only 28 (1.9%) patients in the study cohort were classified as false negatives. In the validation dataset, the NPV was 93.7%, sensitivity was 66%, and 3.3% (17/512) of patients were classified as false negatives. Conclusions: Simple clinical and laboratory parameters obtained on the third POD can be used when making decisions regarding the safe early discharge of patients who underwent gastrectomy.