PURPOSE : To determine the patterns of electromyographic (EMG) responses and torques of upper extremity muscles in overhead throwers during maximal, eccentric muscle action for shoulder flexion (Flex_Ecc), abduction (Abd_Ecc) and diagonal activities (Dia_Ecc) with full glenohumeral internal rotation, at 60, 120, and 180°/s on the dynamometer.METHODS : Seven asymptomatic subjects (7 men, 4 women) who participate in overhead sports at least three days a week volunteered to participate in this study. Subjects were randomly performed with the test procedure which consisted of at least 5 grade maximal-effort repetitions on the three different testing conditions, at 60, 120, and 180°/s on the dynamometer, while we assessed muscle activation of the anterior deltoid (AD), middle deltoid (MD), posterior deltoid (PD), upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and biceps brachii (BB) muscles by surface electromyography. EMG data was expressed as a percentage of maximum voluntary isometric contraction (%MVIC) that was obtained from the highest root mean square (RMS, 50 ms) of each muscle and was normalized and averaged.RESULT : AD muscle elicited lower muscle activity during Dia_Ecc than Flex_Ecc and Abd_Ecc (P＜0.05) while the MD, PD, UT, MT, and LT muscles elicited overall greater muscle activities during Dia_Ecc. MD and MT muscle activities were significantly greater for the faster speed than for the slower speed as 60°/s during Abd_Ecc (P＜0.05). Peak torque generated greater muscle strength for Dia_Ecc than Flex_Ecc and Abd_Ecc, and it was significantly greater for the faster speed than slower speed during Dia_Ecc (P＜0.05).CONCLUSION : Posterior upper extremity muscle activities and peak torque values were found to be dependent on eccentric muscle action for diagonal shoulder activity at the faster speed. This study provided evidence that isokinetic eccentric muscle strength testing of the posterior upper extremity muscle was effective to develop of a proper program for overhead sports athletes require forceful stability during deceleration phase.

BACKGROUND: Korea has high prescribing rate and rising antibiotic resistance. This study was conducted to understand why primary physicians prescribe antibiotics for acute respiratory infections and to explore the factors that influence antibiotic resistance, and so to suggest strategy to reduce antibiotic resistance. METHODS: A qualitative exploratory approach was used using 4 focus groups composed of physicians from different area. A semi-structured guide was applied in obtaining the physicians' opinions. Common themes were extracted by authors, which were used to gather results and draw conclusion. RESULTS: Participants acknowledged multiple factors such as clinical factor and competitive environment are involved in physicians' decision of antibiotic prescribing. They identified that causes of rising antibiotic resistance were shortage of information, discontinuation of taking antibiotics, and other system factors. CONCLUSION: Participants were certain that less prescribing antibiotics and selecting appropriate antibiotics might be method to reduce antibiotic resistance. To change the prescribing behavior, it should be provided periodically for community physicians with prescribing information and specific guidelines for antibiotics resistance. Patients should be also noticed about antibiotic medication information more accurately. Including prescription incentive policy, improvement of healthcare system will be carried out at the same time.
Anti-Bacterial Agents* ; Delivery of Health Care ; Drug Resistance, Microbial ; Focus Groups ; Humans ; Information Dissemination ; Korea ; Methods ; Motivation ; Prescriptions* ; Respiratory Tract Infections

Purpose: This study evaluated aggressive hyperbaric oxygen therapy (HBOT) by understanding various exposure routes of acute carbon monoxide (CO) poisoning, the risk factors causing acute cardiovascular, and neurological toxicity caused by poisoning. Methods: A retrospective study was conducted based on the medical records of 417 acute CO poisoning patients who visited the emergency care unit from March 2017 to August 2019. The exposure routes, HBOT performance, age, sex, medical history (hypertension, diabetes mellitus, ischemic heart disease, heart failure), intentionality, loss of consciousness (LOC), intake with alcohol or sedatives, and initial test results (carboxyhemoglobin (COHb), troponin- I, electrocardiography, echocardiography, brain MRI) were examined. Comparative analysis of the clinical information was conducted between the groups that showed acute cardiovascular toxicity and neurological toxicity, and groups that did not. Results: Among 417 patients diagnosed with acute CO poisoning, 201 cases (48.2%) were intentional, and charcoal briquette was the most common route (169 patients (40.5%)). Two hundred sixteen cases (51.8%) were accidental, and fire was the most common route (135 patients (32.4%)). The exposure route was more diverse with accidental poisoning. Three hundred ninety-nine patients were studied for acute cardiovascular toxicity, and 62 patients (15.5%) were confirmed to be positive. The result was statistically significant in intentionality, LOC, combined sedatives, initial COHb, HTN, and IHD. One hundred two patients were studied for acute neurological toxicity, which was observed in 26 patients (25.5%). The result was statistically significant in age and LOC. Conclusion Active HBOT should be performed to minimize damage to the major organs by identifying the various exposure routes of CO poisoning, risk factors for acute cardiovascular toxicity (intentionality, LOC, combined sedatives, initial COHb, HTN, IHD), and the risk factors for acute neurological toxicity (age, LOC).

PURPOSE: The aim of this study was to evaluate the improvement of osteogenic potential of biphasic calcium phosphate (BCP) bone substitute coated with synthetic cell-binding peptide sequences in a standardized rabbit sinus model. METHODS: Standardized 6-mm diameter defects were created bilaterally on the maxillary sinus of ten male New Zealand white rabbits, receiving BCP bone substitute coated with synthetic cell binding peptide sequences on one side (experimental group) and BCP bone substitute without coating (control group) on the other side. Histologic and histomorphometric analysis of bone formation was carried out after a healing period of 4 or 8 weeks. RESULTS: Histological analysis revealed signs of new bone formation in both experimental groups (4- and 8-week healing groups) with a statistically significant increase in bone formation in the 4-week healing group compared to the control group. However, no statistically significant difference in bone formation was found between the 8-week healing group and the control group. CONCLUSIONS: This study found that BCP bone substitute coated with synthetic cell-binding peptide sequences enhanced osteoinductive potential in a standardized rabbit sinus model and its effectiveness was greater in the 4-week healing group than in the 8-week healing group.
Artificial Cells ; Bone Regeneration ; Bone Substitutes ; Calcium ; Durapatite ; Humans ; Hydroxyapatites ; Male ; Maxillary Sinus ; Oligopeptides ; Osteogenesis ; Rabbits

PURPOSE: The aim of this study was to determine whether biphasic calcium phosphate (BCP) bone substitute with two different concentrations of Escherichia coli-expressed recombinant human bone morphogenetic protein 2 (ErhBMP-2) enhances new bone formation in a standardized rabbit sinus model and to evaluate the concentration-dependent effect of ErhBMP-2. METHODS: Standardized, 6-mm diameter defects were made bilaterally on the maxillary sinus of 20 male New Zealand white rabbits. Following removal of the circular bony windows and reflection of the sinus membrane, BCP bone substitute without coating (control group) was applied into one defect and BCP bone substitute coated with ErhBMP-2 (experimental group) was applied into the other defect for each rabbit. The experimental group was divided into 2 subgroups according to the concentration of ErhBMP-2 (0.05 and 0.5 mg/mL). The animals were allowed to heal for either 4 or 8 weeks and sections of the augmented sinus and surrounding bone were analyzed by microcomputed tomography and histologically. RESULTS: Histologic analysis revealed signs of new bone formation in both the control and experimental groups with a statistically significant increase in bone formation in experimental group 1 (0.05 mg/mL ErhBMP-2 coating) after a 4-week healing period. However, no statistically significant difference was found between experimental group 1 and experimental group 2 (0.5 mg/mL ErhBMP-2 coating) in osteoinductive potential (P<0.05). CONCLUSIONS: ErhBMP-2 administered using a BCP matrix significantly enhanced osteoinductive potential in a standardized rabbit sinus model. A concentration-dependent response was not found in the present study.
Animals ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; Bone Regeneration ; Bone Substitutes ; Calcium ; Durapatite ; Escherichia coli ; Humans ; Hydroxyapatites ; Male ; Maxillary Sinus ; Membranes ; Osteogenesis ; Rabbits ; X-Ray Microtomography

Posterior reversible encephalopathy syndrome (PRES) is a disorder of reversible vasogenic edema which mainly involves the parieto-occipital lobes in various clinical settings. Isolated involvement of the brainstem, basal ganglia, and cerebellum is rare. An 81-year-old female was admitted because of a decreased level of consciousness, and she had a head trauma history a day before. Brain magnetic resonance imaging (MRI) showed extensive confluent T2 hyperintensity with swelling involving the bilateral thalami, brainstem, and cerebellar peduncle without cortical lesions. We reports a case of central-variant PRES after traumatic brain injury.

Posterior reversible encephalopathy syndrome (PRES) is a disorder of reversible vasogenic edema which mainly involves the parieto-occipital lobes in various clinical settings. Isolated involvement of the brainstem, basal ganglia, and cerebellum is rare. An 81-year-old female was admitted because of a decreased level of consciousness, and she had a head trauma history a day before. Brain magnetic resonance imaging (MRI) showed extensive confluent T2 hyperintensity with swelling involving the bilateral thalami, brainstem, and cerebellar peduncle without cortical lesions. We reports a case of central-variant PRES after traumatic brain injury.

Posterior reversible encephalopathy syndrome (PRES) is a disorder of reversible vasogenic edema which mainly involves the parieto-occipital lobes in various clinical settings. Isolated involvement of the brainstem, basal ganglia, and cerebellum is rare. An 81-year-old female was admitted because of a decreased level of consciousness, and she had a head trauma history a day before. Brain magnetic resonance imaging (MRI) showed extensive confluent T2 hyperintensity with swelling involving the bilateral thalami, brainstem, and cerebellar peduncle without cortical lesions. We reports a case of central-variant PRES after traumatic brain injury.

Abdominal aortic occlusion (AAO) caused by detachment of cardiac myxoma (CM) is a very rare complication in patients with CM. Although the nature of CMs has been well established, detachment of CM may cause unexpected serious complications such as vicious embolic events. Actually, in several cases of AAO caused by detachment of CM, it has been reported that CM fragments easily migrated to the brain, heart, and lungs, and caused lifelong neurological complications despite appropriate surgical therapy. Herein, we report a case of a patient with AAO caused by detachment of CM who underwent CM excision and abdominal aortic thromboembolectomy. Additionally, we have presented the preoperative and postoperative images using 64-multidetector computed tomography.
Aorta, Abdominal ; Brain ; Heart ; Humans ; Lung ; Myxoma

Hematopoietic stem cell transplantation remains the only curative option for myelodysplastic syndrome (MDS), but the prevalence of the disease in elderly people limits broad application of the procedure, particularly in lower risk group. Azacitidine has been recently approved by the U.S. Food and Drug Administration for MDS regardless of subtype on French-American-British classification. Adverse effects of azacitidine include gastrointestinal, hematological and infusion-related reactions. Azacitidine induced hepatotoxicity has been reported mainly in patients with previous hepatobiliary disease, e.g., extensive tumor infiltration in liver, liver cirrhosis and cholelithiasis. We report here a case of azacitidine-induced hepatitis under no predisposition to hepatobiliary disease.
Aged ; Azacitidine ; Cholelithiasis ; Classification ; Hematopoietic Stem Cell Transplantation ; Hepatitis ; Humans ; Liver ; Liver Cirrhosis ; Myelodysplastic Syndromes* ; Prevalence ; United States Food and Drug Administration