1.Usefulness of Goal Attainment Scaling in Intensive Stroke Rehabilitation During the Subacute Stage
Youngsu JUNG ; Jaehoon SIM ; Joonhyun PARK ; Jongmoon KIM ; MinYoung KIM
Annals of Rehabilitation Medicine 2020;44(3):181-194
Objective:
To investigate the usefulness of goal attainment scaling (GAS) in intensive stroke rehabilitation during the subacute stage.
Methods:
Medical records of subacute post-stroke patients who had undergone intensive rehabilitation under hospitalization, before and after the application of GAS, were collected. GAS was conducted at the initial evaluation of each patient. Specific goals were suggested by physical and occupational therapists and were determined by the responsible physiatrist. A 5-point scale was used for the GAS score after 4 weeks of rehabilitation according to the preset criteria of each goal. To evaluate the influence of GAS in rehabilitation practice, functional improvements were compared between two patient groups before (n=121) and after (n=141) GAS. To assess progress in GAS practice, the standard GAS score was calculated, and the changes were observed over a 3-year period. The standard GAS score converged to 50 points when the goal was achieved. The therapists who used GAS also completed a survey regarding its usefulness.
Results:
There were no statistical differences in the motor and cognitive outcomes of the patient groups before and after applying GAS scoring. Successive yearly changes in the standard GAS scores showed progressive convergence to 50 points, signaling that the patient’s goal-setting abilities improved. According to the survey, most therapists felt that GAS enhanced the quality of therapies (84.6%).
Conclusion
GAS improved goal-setting for the rehabilitation of subacute post-stroke patients and might have a positive effect on rehabilitation.
2.Acute Disseminated Encephalomyelitis Caused by Scrub Typhus.
Heejeong JEONG ; Heeyoung KANG ; Byeonggeun KWAK ; Youngsu KIM ; Seungnam SON ; Sookyung KIM ; Ki Jong PARK ; Nack Cheon CHOI ; Oh Young KWON ; Byeong Hoon LIM
Journal of the Korean Neurological Association 2011;29(4):385-387
No abstract available.
Encephalomyelitis, Acute Disseminated
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Meningoencephalitis
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Orientia tsutsugamushi
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Scrub Typhus
3.Intensive Rehabilitation Therapy Following Brain Tumor Surgery: A Pilot Study of Effectiveness and Long-Term Satisfaction
Junghoon YU ; Youngsu JUNG ; Joonhyun PARK ; Jong Moon KIM ; Miri SUH ; Kyung Gi CHO ; MinYoung KIM
Annals of Rehabilitation Medicine 2019;43(2):129-141
OBJECTIVE: To evaluate the effectiveness of intensive rehabilitation to support recovery of neurological function after brain tumor surgery and assess long-term satisfaction. METHODS: This retrospective study included patients with neurological impairment after brain tumor surgery who underwent intensive rehabilitation therapy between December 2013 and May 2017. To assess effectiveness of rehabilitation, functional outcomes (motor, cognition, and activities of daily living [ADL]) were compared between brain tumor group and a control group enrolling stroke patients who received equivalent rehabilitation during the study period. Long-term satisfaction with rehabilitation was evaluated by surveying family caregivers. RESULTS: This study included 21 patients with benign brain tumor, 14 with malignant brain tumor, and 108 with stroke. Significant and similar improvement in motor, cognition, and ADL function were noted in both the brain tumor group and the stroke group. Malignancy status did not influence the extent of functional improvement. According to medical records and surveys, 9 (69.2%) patients with malignant tumor and 2 (11.8%) with benign tumor had expired by the time of the survey. Most family caregivers confirmed that rehabilitation was effective for functional improvement (>60%), expressing overall satisfaction and stating they would recommend such therapy to patients with similar conditions (approximately 70%). CONCLUSION: Intensive rehabilitation may help promote functional improvement following brain tumor surgery regardless of malignancy compared with stroke patients. Family caregivers expressed overall satisfaction with rehabilitation at long-term follow-up. These findings support the provision of intensive rehabilitation therapy for neurologic function recovery following brain tumor surgery.
Activities of Daily Living
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Brain Neoplasms
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Brain
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Caregivers
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Cognition
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Follow-Up Studies
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Humans
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Medical Records
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Neurological Rehabilitation
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Pilot Projects
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Recovery of Function
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Rehabilitation
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Retrospective Studies
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Stroke
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Treatment Outcome
4.Comparison of atezolizumab plus bevacizumab and lenvatinib for hepatocellular carcinoma with portal vein tumor thrombosis
Jeayeon PARK ; Yun Bin LEE ; Yunmi KO ; Youngsu PARK ; Hyunjae SHIN ; Moon Haeng HUR ; Min Kyung PARK ; Dae-Won LEE ; Eun Ju CHO ; Kyung-Hun LEE ; Jeong-Hoon LEE ; Su Jong YU ; Tae-Yong KIM ; Yoon Jun KIM ; Tae-You KIM ; Jung-Hwan YOON
Journal of Liver Cancer 2024;24(1):81-91
Background:
/Aim: Atezolizumab plus bevacizumab and lenvatinib are currently available as first-line therapy for the treatment of unresectable hepatocellular carcinoma (HCC). However, comparative efficacy studies are still limited. This study aimed to investigate the effectiveness of these treatments in HCC patients with portal vein tumor thrombosis (PVTT).
Methods:
We retrospectively included patients who received either atezolizumab plus bevacizumab or lenvatinib as first-line systemic therapy for HCC with PVTT. Primary endpoint was overall survival (OS), and secondary endpoints included progressionfree survival (PFS) and disease control rate (DCR) determined by response evaluation criteria in solid tumors, version 1.1.
Results:
A total of 52 patients were included: 30 received atezolizumab plus bevacizumab and 22 received lenvatinib. The median follow-up duration was 6.4 months (interquartile range, 3.9-9.8). The median OS was 10.8 months (95% confidence interval [CI], 5.7 to not estimated) with atezolizumab plus bevacizumab and 5.8 months (95% CI, 4.8 to not estimated) with lenvatinib (P=0.26 by log-rank test). There was no statistically significant difference in OS (adjusted hazard ratio [aHR], 0.71; 95% CI, 0.34-1.49; P=0.37). The median PFS was similar (P=0.63 by log-rank test), with 4.1 months (95% CI, 3.3-7.7) for atezolizumab plus bevacizumab and 4.3 months (95% CI, 2.6-5.8) for lenvatinib (aHR, 0.93; 95% CI, 0.51-1.69; P=0.80). HRs were similar after inverse probability treatment weighting. The DCRs were 23.3% and 18.2% in patients receiving atezolizumab plus bevacizumab and lenvatinib, respectively (P=0.74).
Conclusion
The effectiveness of atezolizumab plus bevacizumab and lenvatinib was comparable for the treatment of HCC with PVTT.
5.Polymorphism in the promoter region of the klotho gene (G-395A) is associated with early dysfunction in vascular access in hemodialysis patients.
Youngsu KIM ; Sun Joo JEONG ; Hyung Suk LEE ; Eun Jung KIM ; Young Rim SONG ; Sung Gyun KIM ; Ji Eun OH ; Young Ki LEE ; Jang Won SEO ; Jong Woo YOON ; Ja Ryong KOO ; Hyung Jik KIM ; Jung Woo NOH ; Seung Ho PARK
The Korean Journal of Internal Medicine 2008;23(4):201-207
BACKGROUND/AIMS: Vascular access dysfunction is an important cause of morbidity and mortality in hemodialysis (HD) patients. Recent studies have shown that a klotho gene mutation is related to endothelial dysfunction, thrombosis, and arteriosclerosis, which are regarded as causes of vascular access dysfunction. We investigated the relationship between the klotho G-395A polymorphism and early dysfunction in vascular access in HD patients. METHODS: Patients who underwent vascular access operations between 1999 and 2002 were enrolled (n=126). Genotyping was performed by allelic discrimination using a 5'-nuclease polymerase chain reaction assay. Clinical data that could be relevant to access dysfunction were obtained from medical records. Early dysfunction of vascular access was defined as the need for any angioplastic or surgical intervention to correct or replace a poorly or nonfunctioning vascular access within 1 year and at least 8 weeks after initial access placement. RESULTS: Of the 126 patients, the genotype frequency of G-395A was 72.2% for GG (n=91), 24.6% for GA (n=31), and 3.2% for AA (n=4), and the frequency of minor allele was 0.155. Clinical data were similar between the two groups, divided according to the status of the A allele. Early dysfunction occurred in 34 (27.0%) of patients, but it occurred at a significantly higher rate in A allele carriers (45.7%, 16/35) than in noncarriers (19.8%, 18/91; p=0.003). CONCLUSIONS: Our results suggest that the klotho G-395A polymorphism could be a risk factor for early dysfunction of vascular access in HD patients.
Aged
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*Arteriovenous Shunt, Surgical
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Catheters, Indwelling
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Cohort Studies
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Female
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Glucuronidase/*genetics
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Humans
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Kidney Failure, Chronic/complications/*genetics/therapy
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Male
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Middle Aged
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Polymorphism, Genetic/*genetics
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Promoter Regions, Genetic/genetics
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*Renal Dialysis
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Vascular Diseases/complications/genetics
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Vascular Patency/*genetics