Background: We aimed to provide basic data for improving the effectiveness of the invitational training and reflecting it in the program in the following year by identifying the satisfaction level of trainees who participated in the “Dr. LEE Jong-wook Fellowship Program” funded by the Korea Foundation for International Healthcare. Methods: A qualitative study was conducted using a questionnaire interview. In the first stage of analysis, only the interview contents related to the research topic were classified by the researcher for the conversations recorded at the interview site, and in the second stage of analysis, the interview contents classified in the first stage were classified into each of those mentioned in this study. Results: The longer the trainees participated in the program and the better the accessibility, the higher the satisfaction with the program. In addition, the level of achievement of the trainees’ goals and the level of improvement in their competence affected their satisfaction, and their difficulty in language communication during the training period was identified as a factor affecting the trainees’ satisfaction level. In addition, competency improvement and satisfaction were positively correlated (r=0.75, p=0.03). Conclusion When organizing a rehabilitation workforce capacity training program, it is important to identify trainees’ needs, ensure accessibility, organize courses effectively, enhance English proficiency, and expand practical lectures to increase trainees’ knowledge and understanding of rehabilitation.

OBJECTIVE: To assess the effect of oral desmopressin administration for nocturia and sleeping in brain injured patients and to confirm its safety. METHOD: 20 brain injured patients waking up more than twice a night for urination during sleeping have been subjected to take 0.1 mg of desmopressin at 9 p.m. everyday for 30 days. To analyze the effect of the drug before and after its administration, the frequency of patient's awakening for urination, duration of time to first urination after sleeping, total urination volume during sleeping and Pittsburgh sleep quality index (PSQI) were evaluated. All newly found symptoms one month after taking the medication were recorded to confirm the safety of the drug. RESULTS: After taking the medication, the mean urination frequency of 20 patients was reduced from 2.4 to 1.4, the mean duration of time to the first urination after sleeping was increased from 3.4 hours to 4.9 hours (p<0.01). The mean PSQI score of 20 patients was decreased from 9.7 to 4.8 (p<0.01). 2 patients had side effects (hyponatremia, headache). CONCLUSION: The oral administration of desmopressin was relatively safe and effective on brain injured patients with nocturia.
Administration, Oral ; Brain ; Deamino Arginine Vasopressin ; Humans ; Nocturia ; Urination

OBJECTIVE: To evaluate the clinical usefulness of ICF (International Classification of Functioning, Disability and Health) through correlation among existing functional evaluation tools and examined environmental factors affecting its function. METHOD: One hundred eight persons with disabilities living in Seoul were randomly selected according to disability severity categories. Functional Independence Measure (FIM), modified Barthel index (MBI) and ICF were examined and subjects were interviewed by trained rehabilitation doctors and occupational therapists. We compared correlation between these three functional measurements. We coded environmental factors affecting function. That was used in second level of 74 ICF items. RESULTS: The average of FIM, modified Barthel index, capacity and performance scores of ICF was 112.76, 92.97, 5.74 and 3.19. There was a statistical correlation among FIM, Barthel index, and ICF. The facilitator chapters among ICF's environmental factors were support and relationships (51.9%), attitudes (45.8%) in order. Most facilitated second level domains among the 68 items were immediate family (66.77%) and health professionals (52.8%). The most barrier chapters in ICF were product and a technology (19.5%), environment changes (15.5%) in order. Most barrier second level domains were design, construction and technology of buildings for public use (37%) and assets (37.0%). CONCLUSION: ICF correlates with the existing functional evaluation tool and can facilitate management of activity and participation by linking the result with the environmental factors, which may exacerbate or minimize them
Disabled Persons ; Health Occupations ; Humans

Objective: The objective of this study is to assess the efficacy and safety of repeated sodium polynucleotide (Conjuran Ⓡ ) treatments in patients with knee osteoarthritis. Methods: The study was conducted by retrospectively examining 45 patients who repeated the treatment course of 5 injections of Conjuran Ⓡ twice within 6 months. For each course, pain reduction by the change of 100-mm Weight-Bearing-Pain Visual-Analog-Scale was compared with before administration until 6 months after administration. Improvement by Clinical Global Impression (CGI) and Patient Global Impression (PGI) were also investigated, as well as adverse reactions. Results: Pain analysis after administration of Conjuran Ⓡ confirmed that VAS decreased by 51.6% until 6 months (p＜0.001), and after that the effect was lost and was repeat for the 2 nd course. In the 2 nd , VAS continued to decrease by 58.7% compared to before the 1 st course (p＜0.001). Analysis of CGI, 88.9% of patients improved after the 1 st and 84.4% of patients improved after the 2 nd . In the PGI results, symptoms improved in 86.7% of patients after the 1 st and 82.2% after the 2 nd . No significant adverse event was reported. Conclusion The safety and efficacy results of patients receiving Conjuran Ⓡ for 2 nd treatment courses were similar to those for 1 st treatment course. In addition, the effect lasts for up to 6 months after administration, and the pain reduction effect is lost thereafter, so it is recommended to apply it at 6-month intervals if additional treatment is needed. Conjuran Ⓡ is an intra-articular injection that is effective in reducing knee pain and can be used repeatedly without adverse reactions.

Erythritol is a natural sugar alcohol found in some fruits and fermented foods, which is used as a dietary sweetener because it has few calories. Here, we describe a 36-year-old woman who experienced anaphylaxis upon ingestion of an erythritol-containing drink. She presented to the emergency department with dyspnea and angioedema after drinking a peachcontaining diet beverage. Her blood pressure dropped to 70/40 mmHg and the symptoms improved after administration of an antihistamine, glucocorticoid, and epinephrine. After 10 days, she drank another peach-containing diet beverage and experienced urticaria. No serumspecific immunoglobulin E findings were observed, including against peach components.A skin prick test (SPT) was performed using a peach, the two ingested diet beverages, and another peach-containing beverage. The SPT results for the peach and the peach-containing product were negative, but the wheal sizes for the two diet beverages were > 3 mm. The diet beverages contained erythritol as a food additive. The SPT result was positive for erythritol. The patient was diagnosed with anaphylaxis to erythritol and was instructed to avoid foods containing erythritol. She was prescribed a self-injectable epinephrine pen. To our knowledge, this is the first case of erythritol-induced anaphylaxis in Korea. Physicians should be aware of the possibility of allergic reactions to food additives, and additives should be evaluated to prevent the recurrence of symptoms.

OBJECTIVE: It was aimed to evaluate the nutritional status of geriatric stroke patients admitted to a convalescent and rehabilitation hospital and the clinical usefulness of the mini-nutritional assessment (MNA) to identify malnutrition in elderly stroke patients. METHOD: We performed a nutritional evaluation using the MNA questionnaire, anthropometric, haematological, and biochemical parameters in 30 stroke patients. Malnutrition was defined if there were abnormalities in at least one of the following parameters: serum values of albumin and transferrin, hemoglobin and total lymphocytes in blood, and body mass index. The sensitivity, specificity, and predictive values of MNA for malnutrition were assessed. RESULTS: The mean age of patients was 69.5 years and mean body mass index was 22.8 kg/m2. The prevalence of malnutrition was 46.7% while malnutrition or risk of malnutrition by MNA was 80%. The sensitivity, specificity, and positive/negative predictive values of MNA for malnutrition were respectively 92.9%, 31.3%, 54.2%, and 83.3% with a cutoff point lower than 23.5. There was a significant difference of hemoglobin value between malnourished and nourished group (p<0.05). CONCLUSION: Malnutrition was common in geriatric stroke patients. MNA was a useful screening tool to exclude nourished geriatric patients.
Aged ; Body Mass Index ; Humans ; Lymphocytes ; Malnutrition ; Mass Screening ; Nutrition Assessment* ; Nutritional Status ; Prevalence ; Surveys and Questionnaires ; Rehabilitation* ; Sensitivity and Specificity ; Stroke* ; Transferrin

Background: The present study evaluated the association between participation in a rehabilitation program during a hospital stay and 1-year survival of patients requiring at least 21 days of mechanical ventilation (prolonged mechanical ventilation [PMV]) with various respiratory diseases as their main diagnoses that led to mechanical ventilation. Methods: Retrospective data of 105 patients (71.4% male, mean age 70.1±11.3 years) who received PMV in the past 5 years were analyzed. Rehabilitation included physiotherapy, physical rehabilitation, and dysphagia treatment program that was individually provided by physiatrists. Results: The main diagnosis leading to mechanical ventilation was pneumonia (n=101, 96.2%) and the 1-year survival rate was 33.3% (n=35). One-year survivors had lower Acute Physiology and Chronic Health Evaluation (APACHE) II score (20.2±5.8 vs. 24.2±7.5, p=0.006) and Sequential Organ Failure Assessment score (6.7±5.6 vs. 8.5±2.7, p=0.001) on the day of intubation than non-survivors. More survivors participated in a rehabilitation program during their hospital stays (88.6% vs. 57.1%, p=0.001). The rehabilitation program was an independent factor for 1-year survival based on the Cox proportional hazard model (hazard ratio, 3.513; 95% confidence interval, 1.785 to 6.930; p<0.001) in patients with APACHE II scores ≤23 (a cutoff value based on Youden’s index). Conclusion Our study showed that participation in a rehabilitation program during hospital stay was associated with an improvement of 1-year survival of PMV patients who had less severe illness on the day of intubation.

Sclerosing ecapsulating peritonitis (SEP) first described by Gandhi and Humyn at 1980 is generally recognized, but uncommon complication of continous ambulatory peritoneal dialysis (CAPD) and the prognosis is very poor. A 62-year old female was admitted to our hospital with chief complaint of abdominal pain, nausea, vomiting. On physical examination, abdominal pain was not detected. Abdominal CT demonstrated paralytic ileus and adhesion in proximal ileum. She underwent adhesilolysis of ileum and repair of perforated ileum. We experienced one case of SEP presenting small bowel perforation and peritonitis in patient with IPD. We report this case with review of the literature.
Abdominal Pain ; Female ; Humans ; Ileum ; Intestinal Pseudo-Obstruction ; Middle Aged ; Nausea ; Peritoneal Dialysis* ; Peritonitis* ; Physical Examination ; Prognosis ; Tomography, X-Ray Computed ; Vomiting

Viperin is a multifunctional protein that was first identified in human primary macrophages treated with interferon-γ and in human fibroblasts infected with human cytomegalovirus. This protein plays a role as an anti-viral protein and a regulator of cell signaling pathways or cellular metabolism when induced in a variety of cells such as fibroblasts, hepatocytes and immune cells including T cells and dendritic cells. However, the role of viperin in macrophages is unknown. Here, we show that viperin is basally expressed in murine bone marrow cells including monocytes. Its expression is maintained in bone marrow monocyte-derived macrophages (BMDMs) depending on macrophage colony-stimulating factor (M-CSF) treatment but not on granulocyte-macrophage colony-stimulating factor (GM-CSF) treatment. In wild type (WT) and viperin knockout (KO) BMDMs differentiated with M-CSF or G-MCSF, there are little differences at the gene expression levels of M1 and M2 macrophage markers such as inducible nitric oxide synthase (iNOS) and arginase-1, and cytokines such as IL-6 and IL-10, indicating that viperin expression in BMDMs does not affect the basal gene expression of macrophage markers and cytokines. However, when BMDMs are completely polarized, the levels of expression of macrophage markers and secretion of cytokines in viperin KO M1 and M2 macrophages are significantly higher than those in WT M1 and M2 macrophages. The data suggest that viperin plays a role as a regulator in polarization of macrophages and secretion of M1 and M2 cytokines.
Bone Marrow ; Bone Marrow Cells ; Cytokines* ; Cytomegalovirus ; Dendritic Cells ; Fibroblasts ; Gene Expression ; Granulocyte-Macrophage Colony-Stimulating Factor ; Hepatocytes ; Humans ; Interleukin-10 ; Interleukin-6 ; Macrophage Colony-Stimulating Factor ; Macrophages* ; Metabolism ; Monocytes ; Nitric Oxide Synthase Type II ; T-Lymphocytes