As South Korea becomes a super-aged society by 2025, the number of patients with Parkinson’s disease (PD) is increasing rapidly. PD is characterized by motor symptoms, such as bradykinesia, tremor, and rigidity, and non-motor symptoms, such as depression, cognitive impairment, and autonomic nervous system disorders. The pathophysiology of dysphagia in PD is a complex interplay of motor disorders caused by dopamine deficiency in the basal ganglia and the involvement of the brainstem swallowing center and the peripheral nerve system affected by the PD pathology. Dysphagia in PD presents difficulties in taking medications, contributes to malnutrition and dehydration, and reduces the overall quality of life. Despite dysphagia being a prevalent problem in PD, a significant number of patients remain unaware of the swallowing difficulties. Therefore, healthcare practitioners need to understand dysphagia in PD, consider early screening and objective evaluations, and proactively implement swallowing treatment and compensatory therapy as needed. This review examines the pathophysiology, clinical characteristics, screening and diagnosis, and severity assessment of dysphagia in PD.

As South Korea becomes a super-aged society by 2025, the number of patients with Parkinson’s disease (PD) is increasing rapidly. PD is characterized by motor symptoms, such as bradykinesia, tremor, and rigidity, and non-motor symptoms, such as depression, cognitive impairment, and autonomic nervous system disorders. The pathophysiology of dysphagia in PD is a complex interplay of motor disorders caused by dopamine deficiency in the basal ganglia and the involvement of the brainstem swallowing center and the peripheral nerve system affected by the PD pathology. Dysphagia in PD presents difficulties in taking medications, contributes to malnutrition and dehydration, and reduces the overall quality of life. Despite dysphagia being a prevalent problem in PD, a significant number of patients remain unaware of the swallowing difficulties. Therefore, healthcare practitioners need to understand dysphagia in PD, consider early screening and objective evaluations, and proactively implement swallowing treatment and compensatory therapy as needed. This review examines the pathophysiology, clinical characteristics, screening and diagnosis, and severity assessment of dysphagia in PD.

As South Korea becomes a super-aged society by 2025, the number of patients with Parkinson’s disease (PD) is increasing rapidly. PD is characterized by motor symptoms, such as bradykinesia, tremor, and rigidity, and non-motor symptoms, such as depression, cognitive impairment, and autonomic nervous system disorders. The pathophysiology of dysphagia in PD is a complex interplay of motor disorders caused by dopamine deficiency in the basal ganglia and the involvement of the brainstem swallowing center and the peripheral nerve system affected by the PD pathology. Dysphagia in PD presents difficulties in taking medications, contributes to malnutrition and dehydration, and reduces the overall quality of life. Despite dysphagia being a prevalent problem in PD, a significant number of patients remain unaware of the swallowing difficulties. Therefore, healthcare practitioners need to understand dysphagia in PD, consider early screening and objective evaluations, and proactively implement swallowing treatment and compensatory therapy as needed. This review examines the pathophysiology, clinical characteristics, screening and diagnosis, and severity assessment of dysphagia in PD.

As South Korea becomes a super-aged society by 2025, the number of patients with Parkinson’s disease (PD) is increasing rapidly. PD is characterized by motor symptoms, such as bradykinesia, tremor, and rigidity, and non-motor symptoms, such as depression, cognitive impairment, and autonomic nervous system disorders. The pathophysiology of dysphagia in PD is a complex interplay of motor disorders caused by dopamine deficiency in the basal ganglia and the involvement of the brainstem swallowing center and the peripheral nerve system affected by the PD pathology. Dysphagia in PD presents difficulties in taking medications, contributes to malnutrition and dehydration, and reduces the overall quality of life. Despite dysphagia being a prevalent problem in PD, a significant number of patients remain unaware of the swallowing difficulties. Therefore, healthcare practitioners need to understand dysphagia in PD, consider early screening and objective evaluations, and proactively implement swallowing treatment and compensatory therapy as needed. This review examines the pathophysiology, clinical characteristics, screening and diagnosis, and severity assessment of dysphagia in PD.

Dysphagia after radiotherapy for head and neck cancer is a common problem that affects the nutritional status and quality of life of patients. In particular, although radiation-induced dysphagia associated with late fibroatrophy is often progressive and intractable, there have been only few studies on the therapeutic options, and preventive efforts are not performed well in clinics. This review summarizes the management of radiation-induced dysphagia and suggests possible medical treatments based on the current evidence and reported pathophysiologic mechanisms.
Deglutition Disorders* ; Disease Management ; Fibrosis ; Head and Neck Neoplasms ; Humans ; Nutritional Status ; Quality of Life ; Radiotherapy

Parkinson's disease (PD) is a neurodegenerative disorder characterized by typical motor symptoms such as resting tremor, bradykinesia, and rigidity, as well as non-motor manifestations, including psychiatric symptoms, autonomic dysfunction, and cognitive impairment. These symptoms induce a marked impact on functional independence in daily activities and quality of life in PD patients. Recent guidelines recommend adequate rehabilitation education and treatment from the early stages of PD, and rehabilitation has become part of standard care for PD. In Korea, the number of patients with PD has more than tripled over 15 years, from 39,265 in 2004 to 125,607 in 2019. However, the rehabilitation usage of PD patients has not changed remarkably, and it remains suboptimal in Korea compared to several developed countries, which have advanced and disseminated guidelines and implemented specialized care delivery systems for PD over the past 20 years. Additional efforts are warranted to provide adequate rehabilitation therapies for PD patients in Korea.

The corrected transposition of the great arteries is a rare congenital heart anomaly consisting of the discordant connections of both the atria to ventricles and the ventricles to the great arteries. But its circulation is physiologically corrected and therefore it is compatible with life unless there are associated lesions. Our case was associated with VSD, COA, and PDA. He was slightly cyanotic and irritable. Despite of oxygen supply, his symptoms were not improved and he eventually died in 52 hours after delivery. Medical record revealed severe respiratory and metabolic acidosis.
Acidosis ; Arteries* ; Heart ; Medical Records ; Oxygen

Immunoglobulin G4-related disease (IgG4-RD) is an autoimmune disorder associated with fibroinflammatory conditions that can affect multiple organs. Hallmark histopathological findings of IgG4-RD include lymphocytic infiltration of IgG4-positive plasma cells, storiform fibrosis, and obliterative phlebitis. However, little is known about central nervous system involvement of IgG4-RD.Hypertrophic pachymeningitis (HP) has recently been reported as a manifestation of IgG4-RD, which may have previously been demonstrated in a significant percentage of idiopathic cases. Herein, we report a rare case of a 63-year-old male who presented with a scalp mass that mimicked a brain tumor. He was diagnosed with IgG4-related HP (IgG4-RP) after surgery. This case suggests that awareness of a possibility of IgG4-RP in patients with isolated scalp masses, even in the absence of systemic symptoms, is crucial. A combination of careful history taking, evaluation of serum IgG4-levels and imaging as an initial work-up, followed by tissue biopsy, is important for the differential diagnosis of IgG4-RP, malignancy, and other infectious diseases.

OBJECTIVE: To investigate the effects of short-term robot-assisted upper limb training on hemiplegic patients compared to conventional physical therapy. METHOD: This study was a prospective, single-blinded, randomized controlled trial. Eighteen hemiplegic patients due to brain lesions were randomly assigned to: (1) robot-assisted upper limb training and conventional upper limb physical therapy for 30 min a day, respectively (Robot group); or (2) conventional upper limb physical therapy for 30 min twice a day (Conventional group). All interventions were provided for 2 weeks, 5 times a week. Each patient was evaluated at pre- and post-treatment by the Fugl-Meyer assessment-upper extremity (FMA-UE), Jebsen hand function test (JHFT), grip power, modified Barthel index-upper extremity (MBI-UE), line bisection test, and Albert test. RESULTS: The Robot group showed significant improvement in FMA-UE (pre: 13.22 +/- 14.20, post: 21.67 +/- 15.84; p = 0.018), MBI-UE (pre: 14.33 +/- 7.42, post: 16.56 +/- 6.95; p = 0.041), and line bisection test (pre: 25.15 +/- 34.48, post: 14.93 +/- 28.38; p = 0.043). The Conventional group showed significant improvement only in MBI-UE (pre: 9.22 +/- 6.06, post: 15.56 +/- 6.19; p = 0.008). The improvement in MBI-UE was larger in the Conventional group than Robot group (6.33 +/- 3.28 vs. 2.22 +/- 2.49; p = 0.014). CONCLUSION: This study suggests that short-term robot-assisted upper limb training may improve upper limb function in hemiplegic patients. However, proper physical therapy may be needed to transfer improved upper limb function to activity of daily living. In addition, goal-directed reaching tasks using a robot are expected to be a treatment option for hemineglect.
Brain ; Extremities ; Hand ; Hand Strength ; Hemiplegia ; Humans ; Perceptual Disorders ; Prospective Studies ; Rehabilitation ; Robotics ; Upper Extremity*

This retrospective case series included five patients who underwent surgical resection of the cervical anterior osteophyte due to dysphagia. Videofluoroscopic swallowing studies (VFSSs) were performed before and after surgery on each patient, and kinematic analysis of the video clips from the VFSS of a 5-mL liquid barium swallow was carried out. Functional oral intake improved after surgery in 3/4 patients who had required a modified diet before surgery. Kinematic analysis showed increases in the maximal hyoid vertical movement length (13.16+/-5.87 to 19.09+/-4.77 mm, p=0.080), hyoid movement velocities (170.24+/-84.71 to 285.53+/-104.55 mm/s, p=0.043), and upper esophageal sphincter opening width (3.97+/-0.42 to 6.39+/-1.32 mm, p=0.043) after surgery. In conclusion, improved upper esophageal sphincter opening via enhancement of hyoid movement after cervical anterior osteophyte resection may be the kinetic mechanism of improved swallowing function.
Barium ; Deglutition Disorders* ; Deglutition* ; Diet ; Esophageal Sphincter, Upper ; Humans ; Hyoid Bone ; Osteophyte* ; Retrospective Studies