No abstract available.
Evoked Potentials, Motor* ; Stroke*

The purpose of this study was to examine the effect of smoking on the clinical, radiographic outcome of surgical peridontal therapy. The outcome of periodontal surgery was evaluated in 51 systemically healthy subjects that had received maintenance care. The study subjects consisted of 26 smokers and 25 non-smokers. The average age of smoking patients was 51 years old and non-smoking patients was 48 years old. Changes of probing pocket depth(PPD) and radiographic bone height, and number of missing teeth compared between smokers and non-smokers during maintenance period after surgical therapy. The clinical parameters were less favorable in the smoking group compared with non-smoking group. The number and percentage of missing teeth were greater in smokers(21.6%) than non- smokers(12.4%), especially in molars. The mean presurgery PPD was similar in smokers and non-smokers, molars and premolars, but significantly decreased at least 2 years after surgery. The mean PPD reduction was significantly greater in nonsmokers than smokers. Both in the smoking and non-smoking group, the mean PPD reduction was significantly greater in premolars than molars. The radiographical evaluation was also less favorable in the smoking group than non-smoking group. The radiographic evaluation of bone height in smokers showed bone loss. On the contrary, bone height of nonsmokers showed bone gain during the period of maintenance. But there was no significant difference between molars and premolars. The clinical and radiographic outcomes of the smoking group was less favorable than those of the nonsmoking group. Therefore, smoking seems to influence on the clinical and radiographic outcomes of surgical periodontal therapy.

Background: Sedentary behavior is associated with increased cardiovascular disease (CVD) risk. We investigated this association of sedentary time and physical activity with increased 10-year CVD risk in Korean adults. Methods: This cross-sectional study used data from the Korea National Health and Nutrition Examination Survey (2014–2017). In total, 14,551 participants aged 30–74 years (6,323 men, 8,228 women) were analyzed. The usual length of sedentary time per day was categorized into three groups (<6, 6–<9, or ≥9 h/d), and physical activity (metabolic equivalents [METs]∙min/wk) was categorized into two groups (low, <600 METs∙min/wk; moderate/high, ≥600 METs∙min/wk). Logistic regression analysis was performed to assess the association between sedentary time and increased CVD risk (predicted 10-year risk ≥10%). Adjusted variables were age, sex, body mass index, marital status, employment, household income, alcohol use, family history of CVD, and comorbidity (hypertension, diabetes, and dyslipidemia). Results: The average sedentary time for the 14,551 participants was 7.49 h/d, with an average 10-year CVD risk of 9.58%. There was no significant association between sedentary time and increased 10-year CVD risk in the moderate/ high physical activity group. In the low physical activity group, sedentary time ≥9 h/d had a significant association with increased CVD risk (odds ratio [OR], 1.29; 95% confidence interval [CI], 1.04–1.62). However, when the sedentary time was <6 h/d, no significant associations were found (OR, 1.17; 95% CI, 0.92–1.49). Conclusion In the low physical activity group, reduction of sedentary time might be important for preventing increased CVD risk.

OBJECTIVE: To estimate the motor unit numbers in normal adult hand muscles using manual incremental technique and F-wave technique. METHOD: We estimated the motor unit numbers in abductor pollicis brevis muscles of twenty normal adults. In manual incremental technique, we estimated the motor unit numbers using motor unit count program setted in electrodiagnostic equipment (Dantec, Keypoint). In F-wave technique, we estimated the motor unit numbers dividing maximal M-potential amplitude by mean amplitude of surface motor unit action potential. RESULTS: There was no significant difference of motor unit numbers between right and left abductor pollicis brevis in both manual incremental and F-wave technique. Motor unit numbers using F-wave technique were significantly greater than motor unit numbers using manual incremental technique. CONCLUSION: The difference of motor unit numbers using manual incremental technique and F-wave technique was considered as a difference of functional electrical stimulation. F-wave technique was more physiologic and functional method of motor unit numbers estimation than manual incremental technique.
Action Potentials ; Adult* ; Electric Stimulation ; Hand ; Humans ; Muscles

OBJECTIVE: To investigate the effectiveness of an upper limb rehabilitation robot therapy on hemispatial neglect in stroke patients. METHODS: Patients were randomly divided into an upper limb rehabilitation robot treatment group (robot group) and a control group. The patients in the robot group received left upper limb training using an upper limb rehabilitation robot. The patients sat on the right side of the robot, so that the monitor of the robot was located on the patients' left side. In this position, patients could focus continuously on the left side. The control group received conventional neglect treatment, such as visual scanning training and range of motion exercises, administered by occupational therapists. Both groups received their respective therapies for 30 minutes a day, 5 days a week for 3 weeks. Several tests were used to evaluate treatment effects before and after the 3-week treatment. RESULTS: In total, 38 patients (20 in the robot group and 18 in the control group) completed the study. After completion of the treatment sessions, both groups showed significant improvements in the Motor-Free Visual Perception Test 3rd edition (MVPT-3), the line bisection test, the star cancellation test, the Albert's test, the Catherine Bergego scale, the Mini-Mental State Examination and the Korean version of Modified Barthel Index. The changes in all measurements showed no significant differences between the two groups. CONCLUSION: This present study showed that the upper limb robot treatment had benefits for hemispatial neglect in stroke patients that were similar to conventional neglect treatment. The upper limb robot treatment could be a therapeutic option in the treatment of hemispatial neglect after stroke.
Exercise ; Humans ; Perceptual Disorders* ; Range of Motion, Articular ; Rehabilitation* ; Robotics ; Stroke* ; Upper Extremity* ; Visual Perception

The aim of this update of Korean clinical practice guidelines for stroke is to provide timely evidence-based recommendations on the antiplatelet therapy in secondary prevention of stroke. Evidence-based recommendations are included for the use of antiplatelet agents for noncardioembolic stroke. Changes in the guidelines necessitated by new evidence will be continuously reflected in the new guideline.
Aspirin ; Platelet Aggregation Inhibitors ; Secondary Prevention ; Stroke ; Ticlopidine

PURPOSE: Despite of the effectiveness of androgen deprivation therapy for prostate cancer, it progress to androgen independent prostate cancer (AIPC) after various periods of time. The objective of this study was to analyze the clinical and pathological variables that predict progression to AIPC after combined androgen blockade (CAB). MATERIALS AND METHODS: We retrospectively reviewed the medical records of 343 patients who were treated with CAB for prostate cancer. Binary logistic regression test was used to analyze the independent predictors for the progression to AIPC. The time to AIPC, according to variables, was assessed by the Kaplan-Meier method and the variables were compared using the Log-Rank test. RESULTS: The mean follow-up was 42.1 months (range: 12-120). Seventy seven patients (33.3%) experienced progression to AIPC at a median of 20.2 months (range: 6-72). On univariate analysis, the percentage of positive prostate biopsies, the Gleason score, the T stage, the extent of bone metastasis, lymph node metastasis, the pretreatment PSA level, the nadir PSA and the PSA level at 3 and 6 months all had a significant relationship with the progression to AIPC. The receiver operating characteristic curve analysis for the nadir PSA showed that the optimal cut-off point to predict progression to AIPC was 0.5ng/ml with an area under curve of 0.769. A multivariate analysis demonstrated that the Gleason score (>7), the nadir PSA (>0.5ng/ml), and the PSA level at 6 months (>4.0ng/ml) were significantly correlated with the progression to AIPC. CONCLUSIONS: This study suggested that Gleason score, the nadir PSA and the PSA level at 6 months were independent variables to predict progression to AIPC after CAB. The PSA level at 6 months may be the most accurate variable to predict progression to AIPC.
Area Under Curve ; Biopsy ; Follow-Up Studies ; Humans ; Logistic Models ; Lymph Nodes ; Medical Records ; Multivariate Analysis ; Neoplasm Grading ; Neoplasm Metastasis ; Prostate* ; Prostatic Neoplasms* ; Retrospective Studies ; ROC Curve

We report a patient with systemic lupus erythematosus (SLE), who had developed metabolic alkalosis during plasmapheresis. The metabolic alkalosis could be promptly corrected by reducing the amount of citrate load. The development of metabolic alkalosis can be explained by the citrate load during plasmapheresis. Careful monitoring of acid base status is mandatory in patients with limited renal function and the reduction of citrate load may be advisable in plasmapheresis.
Adolescent ; Alkalosis/*etiology ; Citrates ; Citric Acid ; Female ; Humans ; Lupus Erythematosus, Systemic/*metabolism/therapy ; Plasmapheresis/*adverse effects/methods

Cardioembolic stroke related to nonvalvular atrial fibrillation is associated with a high recurrence rate and high mortality and morbidity. In this population, therefore, optimal anticoagulant therapy is required to prevent the occurrence of second stroke. Oral anticoagulant, warfarin has been traditionally used, but it is greatly limited by its narrow efficacy window, complex pharmacokinetics, and multiple drug interactions, thus requiring frequent blood monitoring. Recently, oral anticoagulants targeted for a specific coagulation component have been newly developed and tested in large clinical trials. Dabigatran, direct thrombin inhibitor, and rivaroxaban, apixaban, and edoxaban, inhibitors of factor Xa harbor great merits of rapid action time, short half-life, stable plasma concentration, and little drug interaction. Recently, large randomized clinical trials and meta-analyses have been published to show the efficacy and safety of the new oral anticoagulants compared with warfarin. Based on the results from recent clinical trials, we revised recommendations to apply optimal anticoagulant therapy in patients with nonvalvular atrial fibrillation and ischemic stroke or transient ischemic attack.
Anticoagulants ; Atrial Fibrillation* ; Drug Interactions ; Factor Xa ; Half-Life ; Humans ; Ischemic Attack, Transient* ; Mortality ; Pharmacokinetics ; Plasma ; Recurrence ; Secondary Prevention ; Stroke* ; Thrombin ; Warfarin ; Dabigatran ; Rivaroxaban

Intracranial aneurysmal rupture causes subarachnoid hemorrhage which usually leads to fatality or severe disability. Treatment of unruptured intracranial aneurysms (UIAs) can substantially reduce the risk of rupture and prevent the grave consequences, but the risk of prophylactic treatment cannot be ignored. UIAs have diverse characteristics and management strategy needs to be tailored according to their location, size and clinical status. In the absence of level I evidence, the treatment guidance often relied on expert's opinions and experience. Knowledge of the natural course and management risks of individual aneurysms can help to guide treatment decision, but the natural history is still controversial and risks are not clearly defined. The Korean Society of Cerebrovascular Surgeons (KSCVS) decided to issue a Korean version of UIA management guideline as a framework for the treatment decision and as a basis for future studies, following 'Guideline Development Manual' of the Clinical Research Center for Stroke (CRCS). The organized committee systematically reviewed relevant literature and major guidelines published between January 2000 and July 2010 and took a developmental strategy of adaptation rather than de novo methods. On the basis of interpretation of the published evidences, recommendations were synthesized, and the level of evidence and the grade of recommendation were determined using the methods adapted from those of the US Agency for Healthcare Policy and Research and CRCS. The current guideline focuses on three domains of natural history, diagnosis and treatment of UIAs. The hierarchy of evidence and the recommendation grading indicate the current level by the literature and do not indicate the necessity or the prohibition of a certain clinical practice. Accordingly, this guideline cannot provide the answer for every clinical situation and should not take precedence over the clinical judgment of responsible physicians for individual patients. The final judgment regarding the care of a particular patient must be made by the physician and patient in light of circumstances specific to that patient. This is the first version of the UIA management guideline in Korea and new evidences will be timely and continuously updated in the future guidelines.
Aneurysm ; Calcium Hydroxide ; Delivery of Health Care ; Humans ; Intracranial Aneurysm ; Judgment ; Korea ; Light ; Natural History ; Risk Management ; Rupture ; Stroke ; Subarachnoid Hemorrhage ; Zinc Oxide