BACKGROUND: To assess the efficacy of functional electrical stimulation(FES) with multi-joints coordinate movement compared to electric muscular stimulation for mono-joint movement in enhancing the upper extremity motor and functional recovery of hemiplegic survivors. METHODS: Forty patients with hemiplegia were divided into two groups. The FES group received FES to produce hand grip, elbow flexion, elbow extension and hand release in sequence with voluntary movement. Control group received electrical stimulation to produce wrist extension without voluntary movement. All groups received for 20 minutes per session, twice a day, 5 days a week during 4 weeks and under the same occupational and physical therapies during 4 weeks. Outcomes were assessed in a blinded manner with the upper extremity component of the Fugl-Meyer Motor Assessment, the self-care component of the Modified Barthel Index(MBI), Upper extremity muscle strength, Wolf Motor Function Test(WMFT), spasticity, and Range of motion(ROM) of shoulder before and after treatment. RESULTS: There were significant improvements of the power at shoulder & elbow flexion, WMFT, Fugl-Meyer, hand grip, and MBI in both group(p<0.05). ROM of shoulder, the power of wrist extension, and pinch improved only at the FES group(p<0.05). The FES group had better effects at WMFT, Fugl-Meyer, hand grip, pinch, MBI, shoulder ROM, and spasticity after treatment(p<0.05). CONCLUSION: This study showed that FES and multi-joints coordinate movements are better than electric muscular stimulation for mono-joint movement to enhance the upper extremity functional recovery in hemiplegia.
Arm ; Elbow ; Electric Stimulation ; Hand ; Hand Strength ; Hemiplegia ; Humans ; Muscle Spasticity ; Muscle Strength ; Muscles ; Self Care ; Shoulder ; Upper Extremity ; Wolves ; Wrist

BACKGROUND: Recently, the prevalence of obesity has increased due to the development of industries and westernized diet pattern. Also, chronic diseases associated with obesity have increased as well Although management of obese patients is important in health promotion programs, there is no data that supports recognition and management of the obesity in primary care. Therefore, surveys concerning such issues were done among internists and family physicians in Seoul. METHODS: In 1997 May, questionnaire was sent by mail to each 887 internists and family physicians working in primary care in Seoul. RESULTS: A total of 186 replied to the questionnaire consisting of 21% of the total. The proportion of respondents who replied that obesity is a problem for management was 66.3%. Diet control and exercise was recognized as the most effective treatment method 82.1% of respondents recognized that failure to control weight was due to patients themselves. Personal experience in managing obesity patients using informational sources was only 14.5%. The proportion of respondents replied that those whose weight and height were measured for all first-visit patients was 50%, that obese patients received care in was 71%. Behavior modifications, diet control, and exercise were widely recommended, but drug therapy was not. 73.6% of respondents simply explained to control weight to obese patients, but only 17.1% continuously evaluated and managed them. CONCLUSIONS: The degree of recognitions for obesity by primary care physicians in urban area was relatively low,regardless of its importance in health promotion. And, screening for obesity and continuous management for obese patients was inadequate. Efforts to manage obesity patients adequately in primary care is necessary.
Behavior Therapy ; Chronic Disease ; Surveys and Questionnaires ; Diet ; Drug Therapy ; Health Promotion ; Humans ; Mass Screening ; Obesity* ; Physicians, Family ; Physicians, Primary Care ; Postal Service ; Prevalence ; Primary Health Care* ; Seoul

PURPOSE: The aim of this study was to examine the associations between depression, anxiety, hostility and fighting spirit among patients with stomach, colorectal or breast cancer. MATERIALS AND METHODS: 223 patients, diagnosed as with stomach, colorectal or breast cancer, undergoing chemotherapy or follow up care, were the subjects of the study. The study design was cross-sectional at the time of the survey. The degrees of depression, anxiety and hostility of the patients were assessed by the SCL-90-R scores, and the fighting spirit was measured by the Mental Adjustment to Cancer (MAC) scale score. RESULTS: The scores of anxiety and hostility of the patients at younger age were higher than those at older age (p<0.01). The patients with metastasis were more depressed than those without it (p<0.01). There was a negative association between depression and fighting spirit (p<0.001). CONCLUSION: The study showed the more depressed cancer patients had lower fighting spirit score, which was known to be one of the most active psychosocial contributors in adjusting to cancer and survival.
Anxiety* ; Breast Neoplasms ; Depression* ; Drug Therapy ; Follow-Up Studies ; Hostility* ; Humans ; Korea* ; Neoplasm Metastasis ; Stomach

Renin-Angiotensin system (RAS) has been suggested as one of important factors in stress-related responses, and also suggested to be a pro-oxidant in mammals. Studies about antioxidant activity changes in brain by systemic administration of angiotensin II (Ang II) may be valuable data in the clarification of pathogenesis and development of treatment modalities for the psychologic stress-induced somatic disease, such as stress-induced hypertension. We examined, therefore, antioxidant defense changes in the brain induced by Ang II. Antioxidant enzyme activities including superoxide dismutase (SOD), contents of glutathione (GSH), and lipoperoxidation (LPO) were measured in the dissected specimens of the brain regions after subcutaneous injection of human Ang II. In this study, peripheral administration of Ang II decreased LPO in the cerebral cortex, hippocampus, striatum, hypothalamus of Sprague-Dawley rats. Ang II increased activities of SOD, glutathione peroxidase, and glutathione reductase in the hippocampus and striatum. Borderline-hypertensive rats (BHR), a well-known animal model for stress-induced hypertension, showed some differences in the Ang II-induced antioxidant activity changes, comparing with SD rats. In the BHR, peripheral administration of Ang II significantly decreased the activities of antioxidant enzymes and contents of GSH, increased LPO contents in the various regions of brain. These results suggested that oxidative stress on the brain due to Ang II may be greater in the BHR than SDs, and RAS may be one of important pathophysiologic factors for stress-induced hypertension in BHR.
Angiotensin II ; Animals ; Brain* ; Cerebral Cortex ; Glutathione ; Glutathione Peroxidase ; Glutathione Reductase ; Hippocampus ; Humans ; Hypertension ; Hypothalamus ; Injections, Subcutaneous ; Mammals ; Models, Animal ; Oxidative Stress ; Rats* ; Rats, Sprague-Dawley ; Renin-Angiotensin System ; Superoxide Dismutase

BACKGROUND: The test for hippurate hydrolysis is critical for differentiation of C. jejuni and other thermophilic Campylobacter species. So, we evaluated the disk method for detection of hippurate hydrolysis by C. jejuni. METHODS: Twenty-eight Campylobacter species isolated from stool culture were simultaneously tested with disk method for detection of hippurate hydrolysis and polymerase chain reaction (PCR) for hippuricase specific gene. Disk method was tested with difference in incubation time (2 hours vs. 4 hours), hippurate concentration (1%, 2%, and 4%), amount of ninhydrin (50 microliter vs. 100 microliter), and inoculation method (colony vs. suspension of organism adjusted by turbidity), finally, 24 types of disk methods were performed. RESULTS: By using hippuricase PCR method as the reference for the detection of hippurate hydrolysis, the disk method showed a sensitivity of 91.7% and a specificity of 100% when two kinds of disk methods were simultaneously performed. CONCLUSIONS: The disk method for detection of hippurate hydrolysis is simple to use and require fewer cells than the tube method do, and should be useful as a routine diagnostic test in clinical laboratory for rapid identification of C. jejuni.
Campylobacter jejuni* ; Campylobacter* ; Diagnostic Tests, Routine ; Hydrolysis* ; Ninhydrin ; Polymerase Chain Reaction ; Sensitivity and Specificity

The interactions between the tumor microenvironment and tumor cells determine the behavior of the primary tumors. Whether cancer-associated fibroblasts (CAF) have a tumor progressive or a protective role likely depends on the type of tumor cells and the CAF subpopulation. In the present study, we analyzed the prognostic significance of CAF subpopulations in colorectal cancer (CRC). CAF phenotypes were analyzed in 302 CRC patients by using antibodies against podoplanin (PDPN), alpha-smooth muscle actin (alpha-SMA), and S100A4. The relationship between the CAF phenotypes and 11 clinicopathological parameters were evaluated and their prognostic significance was analyzed from the disease-free and overall survival times. We observed that at the tumor invasive front, PDPN CAFs were present in 40% of the cases, and S100A4 or alpha-SMA CAFs were detected in all the cases. PDPN/S100A4 and alpha-SMA/S100A4 dual-stained CAFs were observed in 10% and 40% of the cases, respectively. The PDPN+ CAFs were associated with 6 favorable clinicopathological parameters and prolonged disease-free survival time. The PDPN-/alpha-SMA(high) CAFs were associated with 6 aggressive clinicopathological parameters and tended to exhibit shorter disease-free survival time. On the other hand, the PDPN-/S100A4(high) CAFs were associated with 2 tumor progression parameters, but not with disease prognosis. The PDPN+ CAF phenotype is distinct from the alpha-SMA or S100A4 CAFs in that it is associated with less aggressive tumors and a favorable prognosis, whereas the PDPN-/alpha-SMA(high) or PDPN-/S100A4(high) CAFs are associated with tumor progression in CRC. These findings suggest that CAFs can be a useful prognostic biomarker or potential targets of anti-cancer therapy in CRC.
Actins/immunology/*metabolism ; Adult ; Aged ; Aged, 80 and over ; Antibodies/immunology ; Carcinoembryonic Antigen/blood ; Colorectal Neoplasms/*diagnosis/mortality/pathology ; Disease-Free Survival ; Female ; Fibroblasts/cytology/metabolism ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Male ; Membrane Glycoproteins/immunology/*metabolism ; Middle Aged ; Neoplasm Staging ; Phenotype ; Prognosis ; S100 Proteins/immunology/*metabolism ; Tumor Markers, Biological/metabolism

OBJECTIVE: We analyze pain relief, deformity correction and complication rate after percutaneous kyphoplasty for osteoporotic vertebral compression fractures. METHODS: The authors retrospectively reviewed medical records and radiological findings of 32 patients who underwent percutaneous kyphoplasty for osteoporotic vertebral compression fractures. RESULTS: The patients had significant pain improvement with the procedure. The visual analogue scale score reduced from 8.6 to 3.4 significantly after the procedure. The midline vertebral body height significantly increased postoperatively, but mean kyphotic angle did not. There was no serious complication except one case of epidural cement leakage without neurological impairment. CONCLUSION: Balloon kyphoplasty safely can reduce severe back pain and returned geriatric patients to higher activity levels. The midline vertebral height is restored significantly. However kyphotic deformity correction is not significant as contrary to what we expected from the present study before it was carried out.
Back Pain ; Body Height ; Congenital Abnormalities ; Fractures, Compression* ; Humans ; Kyphoplasty* ; Kyphosis ; Medical Records ; Retrospective Studies

BACKGROUND: Although most of aerobic gram-positive bacilli have been considered to be contaminants, gram-positive bacilli should be identified to the species level if they are isolated from sterile body sites such as blood, and from adequately collected clinical specimens if they are the predominant organisms. However, identification of gram-positive bacilli are difficult due to the enormous diversity of these organisms and the small number of readily available commercial identification systems in clinical laboratories. Gram-positive bacilli and coccorods isolated from blood cultures were tested with BBL Crystal Gram-Positive (GP) Identification (ID) system in order to evaluate the system's usefulness of identifying these bacteria. METHODS: Thirty-seven stock strains of aerobic gram-positive bacteria isolated from blood cultures between October 1998 and November 1999 at Wonju Christian Hospital were simultaneously tested by BBL Crystal GP ID system and API system. Three kinds of API system (API Coryne, API 50 CHB, and API 20 Strep) were tested according to gram stain results. Gram-positive bacilli or gram-positive coccorods consecutively isolated from blood cultures from May to November in 2000 were identified by BBL Crystal GP ID system. RESULTS: Among the 37 stock strains of aerobic gram-positive bacteria, agreement rate of identification between Crystal GP ID system and API system were 88% to the genus level and 63% to the species level in Bacillus species, and 90% to the genus level in Corynebacterium species. The isolation rate of gram-positive bacteria from blood cultures from May to November in 2000 to the genus level were: Bacillus; 41.9%(18/43), Corynebacterium; 37.2%(16/43), and the other grampositive coccorods; 20.9%(9/43). CONCLUSIONS: Crystal GP ID system is a useful identification system which, when combined with basic microbiological tests, should lead to satisfactory identification results for gram-positive bacteria isolated from blood cultures.
Bacillus ; Bacteria ; Corynebacterium ; Gangwon-do ; Gram-Positive Bacteria*

OBJECTIVE: This study was designed to evaluate the effect of functional electrical stimulation on swallowing function in stroke patients with dysphagia. METHOD: The subjects were 22 stroke patients with dysphagia. Functional electrical stimulation was applied to skin over anterior neck for thirty minutes and then, the patients were trained to swallow at the time of maximal stimulation. Swallowing function was evaluated by functional dysphagia scale using videofluoroscopic swallowing study with semisolid material before and 2 weeks after electrical stimulation. RESULTS: There were no significant differences in oral phase scores, the scores of triggering of pharyngeal swallow, residue in piriform sinuses, and coating of pharyngeal wall after swallow of pharyngeal phase. However, the scores of laryngeal elevation and epiglottic closure, residue in valleculae and pharyngeal transit time were significantly decreased (p<0.05). The score of pharyngeal phase was negatively correlated with the pulse intensity. The score of oral phase was negatively correlated with the cognitive function. CONCLUSION: The results of this study showed that the functional electrical stimulation can be used as an additional treatment method for stroke patients with dysphagia.
Deglutition Disorders* ; Deglutition* ; Electric Stimulation* ; Humans ; Neck ; Pyriform Sinus ; Skin ; Stroke*

In order to investigate the status of intestinal helminthic infections in Cambodia, epidemiological surveys were carried out on a national scale, including 19 provinces. A total of 32,201 fecal samples were collected from schoolchildren and adults between 2006 and 2011 and examined once by the Kato-Katz thick smear technique. The overall egg positive rate of intestinal helminths was 26.2%. The prevalence of hookworms was the highest (9.6%), followed by that of Opisthorchis viverrini/minute intestinal flukes (Ov/MIF) (5.7%), Ascaris lumbricoides (4.6%), and Trichuris trichiura (4.1%). Other types of parasites detected were Enterobius vermicularis (1.1%), Taenia spp. (0.4%), and Hymenolepis spp. (0.2%). The northwestern regions such as the Siem Reap, Oddar Meanchey, and Banteay Meanchey Provinces showed higher prevalences (17.4-22.3%) of hookworms than the other localities. The southwestern areas, including Koh Kong and Preah Sihanouk Provinces showed higher prevalences of A. lumbricoides (17.5-19.2%) and T. trichiura (6.1-21.0%). Meanwhile, the central and southern areas, in particular, Takeo and Kampong Cham Provinces, showed high prevalences of Ov/MIF (23.8-24.0%). The results indicate that a considerably high prevalence of intestinal helminths has been revealed in Cambodia, and thus sustained national parasite control projects are necessary to reduce morbidity due to parasitic infections in Cambodia.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Cambodia/epidemiology ; Child ; Feces/*parasitology ; Female ; Helminthiasis/*epidemiology ; Helminths/*classification/*isolation & purification ; Humans ; Intestinal Diseases, Parasitic/*epidemiology ; Male ; Middle Aged ; Prevalence ; Topography, Medical ; Young Adult