Purpose: Anal wounds following hemorrhoidectomy can lead to severe pain and postoperative bleeding, impacting patient recovery and quality of life. Hyaluronic acid (HA) stimulates tissue regeneration and wound healing by accelerating cell migration and proliferation. This study aimed to investigate the differences in wound healing rate and completeness of recovery of perianal wounds topically treated with HA-soaked cotton in a murine model. Methods: Forty-eight 8-week-old Sprague-Dawley rats with perianal wounds created using a biopsy punch were divided into 2 groups: simple dressing with gauze (control) and topical HA-soaked cotton. A single application of HA-soaked cotton was administered after surgery. Wound healing rate and completeness of recovery were evaluated by measuring the healed area and conducting histological analyses. Results: The HA-cotton group exhibited a shorter complete wound healing duration compared to the control group (13.9 days vs. 16.4 days, P = 0.031). Differences in wound healing area between the 2 groups were greatest on postoperative day 2 (51.6% vs. 28.8%, P < 0.001). The HA-cotton group exhibited fewer cases of granulation tissue (2 vs. 5) or redness (0 vs.3) upon complete wound healing. Histologically, the HA-cotton group showed accelerated reepithelialization, rapid shift to lymphocyte-dominant inflammation, enhanced fibroblast proliferation, and increased collagen deposition compared to the control group. Conclusion Herein, topical application of HA-soaked cotton on perianal wounds in rats resulted in accelerated wound healing, particularly in the initial stages, and improved completeness of recovery, underscoring the potential of the topical application of HA-soaked cotton on hemorrhoidectomy wounds in human patients to improve wound healing.

Background: Nilotinib is a tyrosine kinase inhibitor approved by the Ministry of Food and Drug Safety for frontline and 2nd line treatment of Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML). This study aimed to confirm the safety and efficacy of nilotinib in routine clinical practice within South Korea. Methods: An open-label, multicenter, single-arm, 12-week observational post-marketing surveillance (PMS) study was conducted on 669 Korean adult patients with Ph + CML from December 24, 2010, to December 23, 2016. The patients received nilotinib treatment in routine clinical practice settings. Safety was evaluated by all types of adverse events (AEs) during the study period, and efficacy was evaluated by the complete hematological response (CHR) and cytogenetic response. Results: During the study period, AEs occurred in 61.3% (410 patients, 973 events), adverse drug reactions (ADRs) in 40.5% (271/669 patients, 559 events), serious AEs in 4.5% (30 patients, 37 events), and serious ADRs in 0.7% (5 patients, 8 events). Furthermore, unexpected AEs occurred at a rate of 6.9% (46 patients, 55 events) and unexpected ADRs at 1.2% (8 patients, 8 events). As for the efficacy results, CHR was achieved in 89.5% (442/494 patients), and minor cytogenetic response or major cytogenetic response was achieved in 85.8% (139/162 patients). Conclusion This PMS study shows consistent results in terms of safety and efficacy compared with previous studies. Nilotinib was well tolerated and efficacious in adult Korean patients with Ph + CML in routine clinical practice settings.

Objective: To determine the effects of an integrated training device for strength and balance on extremity muscle strength, postural balance, and cognition in older adults using a combination with various rehabilitation training games, in which balance, strength, and cognitive training were configured in a single device. Methods: This prospective study included 20 healthy participants aged 65–85 years. Participants trained for 30 minutes daily, 3 days weekly, for 6 weeks with an integrated training device for strength and balance (SBT-120; Man&Tel Inc., Gumi, Korea). Main outcomes were measured using the Korean Mini-Mental State Examination (K-MMSE), Korean version of the Montreal Cognitive Assessment (K-MoCA), Timed Up and Go Test (TUG), Functional Reach Test (FRT), Berg Balance Scale (BBS), and Manual Muscle Test. Measurements were taken at three time points: T0 (pretreatment), T1 (immediately after treatment), and T2 (4 weeks after treatment). Results: All 20 patients completed the training, and TUG, FRT, and BBS scores significantly improved at T1 and T2 compared to T0. Mean TUG scores decreased by 0.99±2.00 at T1 and 1.05±1.55 at T2 compared to T0. Mean FRT scores increased by 6.13±4.26 at T1 and 6.75±4.79 at T2 compared to T0. BBS scores increased by 0.60±0.94 at T1 and 0.45±1.15 at T2 compared to T0. Moreover, muscle strength and cognition (K-MMSE and K-MoCA scores) increased after training. Conclusion Our findings suggest that an integrated training device for strength and balance can be a safe and useful tool for older adults.

Background/Aims: Although it is near concluded that renin-angiotensin system inhibitors do not have a harmful effect on coronavirus disease 2019 (COVID-19), there is no report about whether angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) offer any protective role. This study aimed to compare the association of ARBs and ACEIs with COVID-19-related mortality. Methods: All patients with COVID-19 in Korea between January 19 and April 16, 2020 were enrolled. The association of ARBs and ACEIs with mortality within 60 days were evaluated. A comparison of hazard ratio (HR) was performed between COVID-19 patients and a retrospective cohort of pneumonia patients hospitalized in 2019 in Korea. Results: Among 10,448 COVID-19 patients, ARBs and ACEIs were prescribed in 1,231 (11.7%) and 57 (0.6%) patients, respectively. After adjusting for age, sex, and history of comorbidities, the ARB group showed neutral association (HR, 1.034; 95% CI, 0.765 to 1.399; p = 0.8270) and the ACEI groups showed no significant associations likely owing to the small population size (HR, 0.736; 95% CI, 0.314 to 1.726; p = 0.4810). When comparing HR between COVID-19 patients and a retrospective cohort of patients hospitalized with pneumonia in 2019, the trend of ACEIs showed similar benefits, whereas the protective effect of ARBs observed in the retrospective cohort was absent in COVID-19 patients. Meta-analyses showed significant positive correlation with survival of ACEIs, whereas a neutral association between ARBs and mortality. Conclusions Although ARBs or ACEIs were not associated with fatal outcomes, potential beneficial effects of ARBs observed in pneumonia were attenuated in COVID-19.

Background/Aims: Although it is near concluded that renin-angiotensin system inhibitors do not have a harmful effect on coronavirus disease 2019 (COVID-19), there is no report about whether angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) offer any protective role. This study aimed to compare the association of ARBs and ACEIs with COVID-19-related mortality. Methods: All patients with COVID-19 in Korea between January 19 and April 16, 2020 were enrolled. The association of ARBs and ACEIs with mortality within 60 days were evaluated. A comparison of hazard ratio (HR) was performed between COVID-19 patients and a retrospective cohort of pneumonia patients hospitalized in 2019 in Korea. Results: Among 10,448 COVID-19 patients, ARBs and ACEIs were prescribed in 1,231 (11.7%) and 57 (0.6%) patients, respectively. After adjusting for age, sex, and history of comorbidities, the ARB group showed neutral association (HR, 1.034; 95% CI, 0.765 to 1.399; p = 0.8270) and the ACEI groups showed no significant associations likely owing to the small population size (HR, 0.736; 95% CI, 0.314 to 1.726; p = 0.4810). When comparing HR between COVID-19 patients and a retrospective cohort of patients hospitalized with pneumonia in 2019, the trend of ACEIs showed similar benefits, whereas the protective effect of ARBs observed in the retrospective cohort was absent in COVID-19 patients. Meta-analyses showed significant positive correlation with survival of ACEIs, whereas a neutral association between ARBs and mortality. Conclusions Although ARBs or ACEIs were not associated with fatal outcomes, potential beneficial effects of ARBs observed in pneumonia were attenuated in COVID-19.

Objective: To determine the effects of an integrated training device for strength and balance on extremity muscle strength, postural balance, and cognition in older adults using a combination with various rehabilitation training games, in which balance, strength, and cognitive training were configured in a single device. Methods: This prospective study included 20 healthy participants aged 65–85 years. Participants trained for 30 minutes daily, 3 days weekly, for 6 weeks with an integrated training device for strength and balance (SBT-120; Man&Tel Inc., Gumi, Korea). Main outcomes were measured using the Korean Mini-Mental State Examination (K-MMSE), Korean version of the Montreal Cognitive Assessment (K-MoCA), Timed Up and Go Test (TUG), Functional Reach Test (FRT), Berg Balance Scale (BBS), and Manual Muscle Test. Measurements were taken at three time points: T0 (pretreatment), T1 (immediately after treatment), and T2 (4 weeks after treatment). Results: All 20 patients completed the training, and TUG, FRT, and BBS scores significantly improved at T1 and T2 compared to T0. Mean TUG scores decreased by 0.99±2.00 at T1 and 1.05±1.55 at T2 compared to T0. Mean FRT scores increased by 6.13±4.26 at T1 and 6.75±4.79 at T2 compared to T0. BBS scores increased by 0.60±0.94 at T1 and 0.45±1.15 at T2 compared to T0. Moreover, muscle strength and cognition (K-MMSE and K-MoCA scores) increased after training. Conclusion Our findings suggest that an integrated training device for strength and balance can be a safe and useful tool for older adults.

We measured the difference of sitting pressure between the affected and unaffected sides (DSPAU) using sitting pressure measured with a force platform to identify sitting imbalance. The aim of this study is to investigate the relations between sitting balance and functional status or parameters according to characteristics stroke patients. We examine changes in DSPAU and functional assessment before and after a 3 week of rehabilitation in hemiplegic stroke patients (n = 73). These pre- and post-treatment data according to stroke characteristics, and correlations between the DSPAU and functional scales were analyzed. The DSPAU was greater in the non-ambulatory group compared to the ambulatory group, in patients who scored lower in the Medical Research Council (MRC) scores, and in patients whose the MRC scores for the lower limbs were lower than of the upper limbs. We observed that a decrease in the DSPAU was associated with an improvement in functional assessment parameters following rehabilitation. Further, changes in DSPAU were significantly correlated to the Modified Barthel Index. We observed that a decrease in DSPAU was associated with an improvement in functional parameters following rehabilitation. In conclusion, repeated measurements of sitting balance using DSPAU may be helpful to predict motor and functional recovery in stroke patient with hemiplegia.
Hemiplegia ; Humans ; Lower Extremity ; Postural Balance ; Recovery of Function ; Rehabilitation ; Stroke ; Upper Extremity ; Weights and Measures

We measured the difference of sitting pressure between the affected and unaffected sides (DSPAU) using sitting pressure measured with a force platform to identify sitting imbalance. The aim of this study is to investigate the relations between sitting balance and functional status or parameters according to characteristics stroke patients. We examine changes in DSPAU and functional assessment before and after a 3 week of rehabilitation in hemiplegic stroke patients (n = 73). These pre- and post-treatment data according to stroke characteristics, and correlations between the DSPAU and functional scales were analyzed. The DSPAU was greater in the non-ambulatory group compared to the ambulatory group, in patients who scored lower in the Medical Research Council (MRC) scores, and in patients whose the MRC scores for the lower limbs were lower than of the upper limbs. We observed that a decrease in the DSPAU was associated with an improvement in functional assessment parameters following rehabilitation. Further, changes in DSPAU were significantly correlated to the Modified Barthel Index. We observed that a decrease in DSPAU was associated with an improvement in functional parameters following rehabilitation. In conclusion, repeated measurements of sitting balance using DSPAU may be helpful to predict motor and functional recovery in stroke patient with hemiplegia.

Bertolotti's syndrome (BS) is a disease that should be differentiated from low back pain (LBP) in young patients. BS shows an anatomical abnormality in which elongated transverse processes of the last lumbar vertebra articulate or fuse with varying degrees to the sacrum or ilium according to radiologic findings, which is associated with the clinical feature of LBP or radiating pain. In this case report, we describe various clinical features such as a waddling gait with severe foot and triceps surae muscle pain, in addition to the typical symptom of BS such as LBP. We report the various clinical symptoms and treatment progress in this case and review the literature.

We measured the difference of sitting pressure between the affected and unaffected sides (DSPAU) using sitting pressure measured with a force platform to identify sitting imbalance. The aim of this study is to investigate the relations between sitting balance and functional status or parameters according to characteristics stroke patients. We examine changes in DSPAU and functional assessment before and after a 3 week of rehabilitation in hemiplegic stroke patients (n = 73). These pre- and post-treatment data according to stroke characteristics, and correlations between the DSPAU and functional scales were analyzed. The DSPAU was greater in the non-ambulatory group compared to the ambulatory group, in patients who scored lower in the Medical Research Council (MRC) scores, and in patients whose the MRC scores for the lower limbs were lower than of the upper limbs. We observed that a decrease in the DSPAU was associated with an improvement in functional assessment parameters following rehabilitation. Further, changes in DSPAU were significantly correlated to the Modified Barthel Index. We observed that a decrease in DSPAU was associated with an improvement in functional parameters following rehabilitation. In conclusion, repeated measurements of sitting balance using DSPAU may be helpful to predict motor and functional recovery in stroke patient with hemiplegia.