• Journal of The Korean Society of Emergency Medicine
• /
• v.28 no.5
• /
• pp.457-466
• /
• 2017

Purpose: Traumatic brain injury (TBI) is a significant cause of morbidity and mortality worldwide. Severity of the initial insult is one of the most significant factors affecting outcome following TBI. In order to investigate the mechanisms of cellular injury and develop novel therapeutic strategies for TBI, we designed a standardized animal TBI model and evaluated histological and functional outcomes according to the degree of impact severity. Methods: Male adult C57Bl/6 mice underwent controlled cortical impact (CCI) at varying depths of deflection (1.0-2.0 mm). We performed hematoxylin and eosin staining at 7 days after recovery from TBI. Neurobehavioral characterization after TBI was analyzed by the Barnes maze test, passive avoidance test, open field test, rotarod test, tail suspension test, and light/dark test. Results: We observed a graded injury response according to the degree of deflection depths tested (diameter, 3 mm; velocity, 3 m/s; and duration, 500 ms) compared to sham controls. In the Barnes maze test, the severe TBI (2 mm depth) group showed reduced spatial memory as compared with the sham and mild TBI (1 mm depth) groups at 7 days after TBI. There was a significant difference in the results of the open field test and light/dark test among the three groups. Conclusion: Our findings demonstrate that the graded injury responses following TBI resulted in differential histopathological and behavioral outcomes in a mouse experimental CCI model. Thus, a model of CCI with histologic/behavioral outcome analysis may offer a reliable and convenient design for preclinical TBI research involving mice.

• Journal of Ginseng Research
• /
• v.39 no.1
• /
• pp.46-53
• /
• 2015

Background: Glucocorticoids (GCs) are commonly used in many chemotherapeutic protocols and play an important role in the normal regulation of bone remodeling. However, the prolonged use of GCs results in osteoporosis, which is partially due to apoptosis of osteoblasts and osteocytes. In this study, effects of Korean Red Ginseng (KRG) on GC-treated murine osteoblastic MC3T3-E1 cells and a GC-induced osteoporosis mouse model were investigated. Methods: MC3T3-E1 cells were exposed to dexamethasone (Dex) with or without KRG and cell viability was measured by the 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. Realtime polymerase chain reaction was performed to evaluate the apoptotic gene expression; osteogenic gene expression and alkaline phosphatase (ALP) activity were also measured. Western blotting was performed to evaluate the mitogen-activated protein kinase (MAPK) proteins. A GC-induced osteoporosis animal model was used for in vivo study. Results and conclusion: The MTT assay revealed that Korean Red Ginseng (KRG) prevents loss of cell viability caused by Dex-induced apoptosis in MC3T3E1 cells. Real-time polymerase chain reaction data showed that groups treated with both Dex and KRG exhibited lower mRNA levels of caspase-3 and -9, whereas the mRNA levels of Bcl2, IAPs, and XIAP increased. Moreover, groups treated with both Dex and KRG demonstrated increased mRNA levels of ALP, RUNX2, and bone morphogenic proteins as well as increased ALP activity in MC3T3-E1 cells, compared to cells treated with Dex only. In addition, KRG increased protein kinase B (AKT) phosphorylation and decreased c-Jun N-terminal kinase (JNK) phosphorylation. Moreover, microcomputed tomography analysis of the femurs showed that GC implantation caused trabecular bone loss. However, a significant reduction of bone loss was observed in the KRG-treated group. These results suggest that the molecular mechanism of KRG in the GC-induced apoptosis may lead to the development of therapeutic strategies to prevent and/or delay osteoporosis.

• Journal of Chest Surgery
• /
• v.52 no.4
• /
• pp.221-226
• /
• 2019

Background: Accurate mediastinal lymph node staging is vital for the optimal therapy and prognostication of patients with lung cancer. This study aimed to determine the preoperative risk factors for pN2 disease, as well as its incidence and long-term outcomes, in patients with clinical N0-1 non-small cell lung cancer. Methods: We retrospectively analyzed patients who were treated surgically for primary non-small cell lung cancer from November 2005 to December 2014. Patients staged as clinical N0-1 via chest computed tomography (CT) and positron emission tomography (PET)-CT were divided into two groups (pN0-1 and pN2) and compared. Results: In a univariate analysis, the significant preoperative risk factors for pN2 included a large tumor size (p=0.083), high maximum standard uptake value on PET (p<0.001), and central location of the tumor (p<0.001). In a multivariate analysis, central location of the tumor (p<0.001) remained a significant preoperative risk factor for pN2 status. The 5-year overall survival rates were 75% and 22.9% in the pN0-1 and pN2 groups, respectively, and 50% and 78.2% in the patients with centrally located and peripherally located tumors, respectively. In a Cox proportional hazard model, central location of the tumor increased the risk of death by 3.4-fold (p<0.001). Conclusion: More invasive procedures should be considered when preoperative risk factors are identified in order to improve the efficacy of diagnostic and therapeutic plans and, consequently, the patient's prognosis.

• Therapeutic Science for Rehabilitation
• /
• v.8 no.1
• /
• pp.51-62
• /
• 2019

Objective: To develop and verify the usability of a cognitive rehabilitation system with diverse cognitive functional levels based on tangible objects for the elderly population. Methods: A study was conducted to investigate the system's strengths and weaknesses by upgrading it with responses from two groups of 15 patients and 4 occupational therapists. After undergoing three forms of training - regarding executive function, memory, and concentration for a total of 20-30 min, the participants were asked to answer a structured questionnaire about contents of the three forms of training, hardware including the tablet PC functioning as a CPU and display media and tangible objects, and satisfaction of experiential usage of the system. Results: Both groups responded that the most interesting training area was executive function while the least interesting was concentration. Six participants reported that the size of the screen of the tablet PC was inappropriate, and five responded that the size of the tool was inappropriate. All therapists and 40% of the patients responded that they were satisfied with this system. Conclusion: This system's features include easy manipulation of tangible tools for performing training tasks, easy selection of and training in cognitive areas based on users' needs, and automatic adjustment of difficulty level based on users' performance. The training environment was designed to be similar to the natural environment by using tangible objects in both hands as input devices for the system, and the system was considered as an alternative to the lack of community cognitive rehabilitation specialists.

• Therapeutic Science for Rehabilitation
• /
• v.10 no.1
• /
• pp.115-127
• /
• 2021

Objective : The purpose of this study was to investigate the effect of telerehabilitation on executive function, activities of daily living, instrumental activities of daily living, and occupational performance in stroke patients. Methods : The participants of this study were 30 outpatients with stroke residing in community. Both groups underwent the intervention 3 times a week for a total of 18 sessions. For the experimental group telerehabilitation was administered at home to only fifteen participants in the experimental group schedule, and it was supervised by the caregiver. Fifteen people in the control group underwent only the traditional occupational therapy. Executive function and instrumental activities of daily living were evaluated using the Korean version of the Executive Function Performance Test (EFPT-K). The basic daily activities of living were assessed using the Modified Barthel Index (MBI). The Canadian Occupational Performance Measure (COPM) was used to evaluate the client-centered occupational performance. Results : After the intervention, the experimental and control groups showed improvements in executive function, instrumental activities of daily living and occupational performance. Occupational performance improved more significantly in the experimental group than in the control group. Conclusion : Telerehabilitation and occupational therapy positively affect executive function, instrumental activities of daily living and occupational performance of patients with stroke. We suggest that telerehabilitation combined with occupational therapy is more effective in improving the occupational performance of stroke patients.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
• /
• v.60 no.5
• /
• pp.209-214
• /
• 2017

Background and Objectives Tinnitus retraining therapy (TRT) is one of the most effective treatment modalities of tinnitus based on the neurophysiological model proposed by Jastreboff and Hazell. This study was performed to evaluate the effect of counselor factor on treatment outcomes of TRT. Subjects and Method The total of 78 patients who had TRT from three different counselors in a tinnitus clinic of tertiary referral center from Jan 2015 to Dec 2015 were included in this study. Their medical records were retrospectively reviewed to evaluate the therapeutic response to TRT. Results Among 78 patients who were followed-up for more than 6 months, 47, 20, and 11 patients were treated by counselors A, B, C (all ENT specialists), respectively. Counselor A had 15-year-experience of TRT counseling, whereas counselor B and C were well trained but beginners of TRT counseling. Initial clinical characteristics including Tinnitus Handicap Inventory (THI) and tinnitus Visual Analogue Scale (VAS) scores of the patients among three groups were not significantly different. Treatment responses evaluated via THI and most of the tinnitus VAS scores after at least 6 months after TRT were significantly improved in all three groups (p<0.05) with no significant difference between the senior (A) and junior (B, C) group. Conclusion TRT seems to be an effective treatment modality of tinnitus even in this short term follow-up study. Treatment outcomes of TRT may not depend on the counselors once they are well trained and follow the same protocol.

• Journal of Music and Human Behavior
• /
• v.19 no.1
• /
• pp.93-112
• /
• 2022

The purpose of this study was to compare participants' perceived emotion following harmonic changes in music. In this study, 144 participants, aged 19 to 29 years, listened to music online that included low to high harmonic progression in tonal music (major-minor). After listening to each piece of music, participants were asked to rate 4 items using a 7-point Likert scale: emotional potency, arousal, degree to which the harmony impacted the listener's emotions, and listener's preference for the music. There were significant differences between each of the four items upon the level of harmonic progression. When the participants were divided into two groups (i.e., those with a background in music and those with no background in music), there was a significant difference between the groups in terms of emotional potency, but there was no significant interaction effect. This study confirmed that various emotional responses in listeners can be induced by controlling the exogenous variables in musical excerpts. Based on this, it is expected that the harmonic progression level can be provided to the client to be used as an effective therapeutic tool in music therapy intervention.

• Therapeutic Science for Rehabilitation
• /
• v.11 no.3
• /
• pp.65-80
• /
• 2022

Objective : This study examined the psychometric properties of the 12-item Coping Orientation to Problems Experienced Scale (COPE) using Rasch analysis. COPE is one of the instruments used to measure stress-coping skills. Methods : The study participants were 480 community-dwelling older adults. We tested the instrument's unidimensionality assumption using principal component analysis (PCA). Item fit was examined using infit-and-outfit mean-square (MnSq) and standardized fit statistics (ZSTD). The precision and item difficulty hierarchies of the instrument were examined. The item-difficulty hierarchy was investigated to identify the easy and difficult items. We tested differential item functioning (DIF) for sex and age groups. Results : PCA revealed that the instrument met the unidimensionality assumption (eigenvalue = 1.78). Among the 12 items, item 2 was removed because of misfit (Infit MnSq = 1.33, Infit ZSTD = 5.05, Outfit MnSq = 1.56, Outfit ZSTD = 7.15). The remaining 11 items demonstrated a conceptual item-difficulty hierarchy. The person strata value was 3.10, which is equivalent to a reliability index value of 0.81. There was no DIF for the sex and age groups (DIF contrast <0.27). Conclusion : The findings indicated that the revised COPE-11 has adequate item-level psychometric properties and can accurately measure stress coping skills.

• Journal of Korean Foot and Ankle Society
• /
• v.27 no.3
• /
• pp.93-98
• /
• 2023

Purpose: This study compared the functional and cosmetic treatment outcomes of intramedullary nailing (IM nail) and minimally invasive plate osteosynthesis (MIPO) for distal tibia shaft fractures. Materials and Methods: Forty-eight patients with distal tibia shaft fractures (distal 1/3 of the diaphysis, AO/OTA [AO Foundation/Orthopaedic Trauma Association]) 43 managed by an IM nail (n=30) or MIPO (n=18) who had minimum one-year follow-up were enrolled in this study. The radiological, functional, and cosmetic outcomes in the two groups were compared retrospectively. Results: All patients achieved bone union. The mean bone union time of the IM nail and MIPO groups was 18.5 and 22.6 weeks, respectively (p=0.078). One patient in the MIPO group showed posterior angulation and valgus deformity of more than five degrees. The mean American Orthopaedic Foot and Ankle Society (AOFAS) functional scores were similar: 83.3 in the IM nail group and 84.6 in the MIPO group (p=0.289). The most salient difference was the cosmetic result of the surgical scar. The length of the scars around the ankle in the IM nail group was significantly smaller than the MIPO group (2.6 cm vs. 10.6 cm; p=0.035). The patient satisfaction survey of surgical scars revealed a significantly higher satisfaction rate in the IM nail group than in the MIPO group (93% vs. 44%; p<0.001). Conclusion: This study showed that both treatment methods for distal tibia shaft fractures have similar therapeutic efficacy regarding the radiological and functional outcomes. On the other hand, the IM nail technique showed superior cosmetic outcomes than the MIPO technique. IM nails may be more recommended in patients with high demand for cosmetic results.

• Exercise Science
• /
• v.21 no.3
• /
• pp.289-298
• /
• 2012

In the present study, we investigated the effect of treadmill exercise on apoptotic neuronal cell death in the retinas of streptozotocin-induced diabetic rats. Twenty-eight male Sprague-Dawley rats were used for this study. The animals were divided into four groups(n = 7 in each group):(1) control group, (2) exercise group, (3) diabetes-induced group, (4) diabetes-induced and exercise group. Diabetes mellitus(DM) was induced by intraperitoneal injection of streptozotocin. The rats in the exercise groups were forced to run on the treadmill for 30 minutes once a day, five times per a week, during 12 weeks. In this study, a terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL) assay and western blot for the expressions of caspase-3, cytochrome c, Bax, and Bcl-2 in the retinas were conducted for the detection of apoptotic retinal cell death. The present results showed that the number of TUNEL-positive cells was increased in the retinas of the diabetic rats, whereas treadmill exercise suppressed this number. The expressions of pro-apoptotic factors caspase-3, cytochrome c, and Bax were enhanced and the expressions of anti-apoptotic factor Bcl-2 was decreased in the retinas of the diabetic rats. In contrast, treadmill exercise suppressed the expressions of caspase-3, cytochrome c, and Bax and increased the expression of Bcl-2. The present study demonstrated that treadmill exercise suppressed diabetes-induced apoptotic neuronal cell death in the retinas. Based on the present results, treadmill exercise may be effective therapeutic strategy for the alleviating complications of diabetes patients.