Objective: To evaluate the diagnostic performance of susceptibility map-weighted imaging (SMwI) taken in different acquisition planes for discriminating patients with neurodegenerative parkinsonism from those without. Materials and Methods: This retrospective, observational, single-institution study enrolled consecutive patients who visited movement disorder clinics and underwent brain MRI and 18F-FP-CIT PET between September 2021 and December 2021. SMwI images were acquired in both the oblique (perpendicular to the midbrain) and the anterior commissure-posterior commissure (AC-PC) planes. Hyperintensity in the substantia nigra was determined by two neuroradiologists. 18F-FP-CIT PET was used as the reference standard. Inter-rater agreement was assessed using Cohen’s kappa coefficient. The diagnostic performance of SMwI in the two planes was analyzed separately for the right and left substantia nigra. Multivariable logistic regression analysis with generalized estimating equations was applied to compare the diagnostic performance of the two planes. Results: In total, 194 patients were included, of whom 105 and 103 had positive results on 18F-FP-CIT PET in the left and right substantia nigra, respectively. Good inter-rater agreement in the oblique (κ = 0.772/0.658 for left/right) and AC-PC planes (0.730/0.741 for left/right) was confirmed. The pooled sensitivities for two readers were 86.4% (178/206, left) and 83.3% (175/210, right) in the oblique plane and 87.4% (180/206, left) and 87.6% (184/210, right) in the AC-PC plane. The pooled specificities for two readers were 83.5% (152/182, left) and 82.0% (146/178, right) in the oblique plane, and 83.5% (152/182, left) and 86.0% (153/178, right) in the AC-PC plane. There were no significant differences in the diagnostic performance between the two planes (P > 0.05). Conclusion There are no significant difference in the diagnostic performance of SMwI performed in the oblique and AC-PC plane in discriminating patients with parkinsonism from those without. This finding affirms that each institution may choose the imaging plane for SMwI according to their clinical settings.

Purpose: Moderate-intensity continuous training (MICT) improves exercise capacity with vascular benefits, but time constraints hinder consistent adherence. High-intensity interval training (HIIT) has emerged as a time-efficient alternative, with repeated sprint training (RST) being the shortest format. We hypothesized that RST would be as effective as MICT in improving vascular function and exercise capacity in young adults. Methods: Twenty-three adults (mean age, 26.2±3.8 years) were randomly assigned to either RST or MICT. RST involved 20 sets of 4-second cycling sprints followed by 30-second active recovery, totaling 11 minutes. MICT consisted of 30-minute cycling at 50% to 60% of heart rate reserve. Vascular function evaluated via brachial artery flow-mediated dilation. Exercise capacity (maximum oxygen uptake, total exercise load test time) and anaerobic capacity (maximum power, anaerobic threshold) were measured using maximum exercise tests. These variables were measured befre and after a 6-week training. Results: Both groups showed comparable improvements in flow-mediated dilation (p＜ 0.05). Maximum oxygen intake slightly improved, while total exercise time significantly increased for both (p＜ 0.05). Anaerobic threshold unchanged, while maximum power improved (p＜ 0.05). Conclusion These findings underscore that RST is a time-efficient exercise strategy, which improves vascular function and exercise capacity as effectively as MICT in young adults.

Purpose: Regular aerobic exercise improves exercise capacity and quality of life in children with congenital heart disease (CHD), but it remains unclear whether aerobic exercise would improve vascular function in children with CHD. We tested the hypothesis that acute bout of virtual reality (VR) exergame would improve vascular function in children with CHD. Methods: In a single-arm study, eight children (age, 9±1 years; five males) with CHD participated in VR exergame (30 minutes at 40% of heart rate reserve) using a stationary cycle ergometer with a head mount display. Endothelial function and arterial stiffness as surrogate markers of vascular function were assessed via reactive hyperemia index (RHI) and augmentation index (AIx) using peripheral arterial tonometry at baseline and 30 minutes after VR exergame. Results: Compared to baseline, VR exergame improved in RHI (1.08 [0.96–1.30] to 1.16 [1.09–1.36], p＜ 0.05) and natural log transformed RHI (0.07 [−0.04–0.26] to 0.15 [0.09–0.31], p＜ 0.05). However, no significant changes were observed for decrease AIx (−1.00 [−9.00–9.50] to −7.00 [−14.00–8.75], p=0.547) and AIx@75 (−6.50 [9.75–3.50] to −4.50 [−13.00–4.50], p=0.735) (all index values are reported as median [interquartile range]). Conclusion These findings suggest that a single bout of VR exergame has the potential to improve vascular endothelial function in children with CHD.

Purpose: Numerous studies have reported the effects of interrupting prolonged sitting with aerobic exercise on vascular and postprandial function, but the effects of resistance exercise for interrupting prolonged sitting remain unclear. We tested the hypothesis that intermittent resistance activity breaks would attenuate prolonged sittinginduced vascular and postprandial metabolic dysfunction. Methods: Fourteen healthy adults (age, 24±2 years; body mass index, 22.0±2.4 kg/m2 ) completed two trials in a randomized cross-over design. During a 4-hour sitting after a high-fat meal, the participants underwent either resistance activity (RA) with 10 repetitions of five exercises every hour or uninterrupted sitting as a control trial (SIT). Plasma glucose, triglycerides, and brachial artery blood pressure, along with blood flow and shear rate in the superficial femoral artery and carotid artery were measured at baseline and every hour during the 4-hour sitting period. Brachial artery flow-mediated dilation (FMD) was measured at baseline, 2 hours, and 4 hours after the start of the sitting. Results: Plasma glucose and triglycerides increased after a high-fat meal in both RA and SIT groups without a significant interaction effect. In addition, while SIT group decreased brachial artery FMD (7.2%±2.0% to 6.5%±2.7% to 5.1%±2.6%), RA did not attenuate a decrease in FMD (7.6%±3.4% to 7.3%±3.1% to 6.7%±2.7%, interaction p=0.581). Conclusion Our findings indicate that interrupting prolonged sitting with intermittent RA did not attenuate the negative effects of sitting on vascular function and postprandial metabolism in young healthy adults.

Purpose: This study investigated the immediate biomechanical effects of unilateral mastication for 10 minutes on the temporomandibular joint (TMJ) with 21 healthy adult participants. Methods: The gum group chewed gum on the right side for 10 minutes, and the control group rested for 10 minutes. Biomechanical data were obtained using a three-dimensional infrared camera before and after intervention. An independent t-test assessed the variation of kinematic data to identify differences between before and after intervention. Results: Among biomechanical variables, the gum group’s length of the left forehead middle region and the temporomandibular joint angle decreased compared to the control group (p<0.05). Conclusion Caution with unilateral masticatory activity is recommended, as unilateral mastication causes biomechanical changes due to excessive load on the soft tissues of the contralateral TMJ.

Background: In addition to vascular endothelial cells, vascular smooth muscle cells (VSMCs) are subject to continuous shear stress because of blood circulation. The angiogenic properties of VSMCs in extracranial arteriovenous malformations (AVMs) may exceed those of normal blood vessels if the body responds more sensitively to mechanical stimuli. This study was performed to investigate the hypothesis that rapid angiogenesis may be achieved by mechanical shear stress. Methods: VSMCs were obtained from six patients who had AVMs and six normal controls. The target genes were set to angiopoietin-2 (AGP2), aquaporin-1 (AQP1), and transforming growth factor-beta receptor 1 (TGFBR1). Reverse-transcriptase polymerase chain reaction (RT-PCR) and real-time PCR were implemented to identify the expression levels for target genes. Immunofluorescence was also conducted. Results: Under the shear stress condition, mean relative quantity values of AGP2, AQP1, and TGFBR1 in AVM tissues were 1.927±0.528, 1.291±0.031, and 2.284±1.461 when compared with neutral conditions. The expression levels of all three genes in AVMs were higher than those in normal tissue except for AQP1 under shear stress conditions. Immunofluorescence also revealed increased staining of shear stress-induced genes in the normal tissue and in AVM tissue. Conclusions Shear stress made the VSMCs of AVMs more sensitive. Although the pathogenesis of AVMs remains unclear, our study showed that biomechanical stimulation imposed by shear stress may aggravate angiogenesis in AVMs.

Background and Objectives: A large-scale community-based study of the general population has not been conducted. There have been no studies on the relationship between decreased renal function and the degree of hearing loss. Thus, the purpose was to evaluate the relationship between hearing loss and impaired renal function with a large number of populations.Subjects and Method We performed a cross-sectional population-based cohort study by enrolling 470718 adults, 18 to 80 years old with pure tone audiometry tests who had regular health screening between 2013 and 2018. Hearing loss was defined as a pure-tone average of thresholds at 500, 1000, and 2000 Hz in both right and left ears. Kidney function was evaluated based on eGFR. Chronic kidney disease (CKD) was diagnosed as an eGFR<60 mL/ min/1.73 m². Other predictor variables including noise and age that can affect hearing were also used to evaluate correlation factors. Results: Of Participants with CKD, 14.2% had any hearing loss (>25 dB) and 5.0% had above moderate hearing loss (>40 dB). But those with normal kidney function, 2.0% either had any hearing loss and 0.4% had above moderate hearing loss. The odds ratio (OR) of above moderate hearing loss for participants with CKD was 1.51 (95% confidence interval [CI]: 1.15-2.00, p=0.003) but the OR of mild hearing loss for participants with CKD was 0.82 (95% CI: 0.67- 1.02, p=0.073). The result suggested that CKD and above moderate hearing loss were related even after correcting for potential confounders, but had no statistical significance with mild hearing loss. Conclusion Decreased kidney function is associated with above moderate hearing loss.

Background: Reversal of neuromuscular blockade (NMB) at the end of surgery is important for reducing postoperative residual NMB; this is associated with an increased risk of postoperative pulmonary complications (PPCs). Moreover, PPCs are associated with poor prognosis after video-assisted thoracoscopic surgery (VATS) for lobectomy. We compared the effects of two reversal agents, sugammadex and neostigmine, on the incidence of PPCs and duration of hospital stay in patients undergoing VATS lobectomy. Methods: After VATS lobectomy was completed under neuromuscular monitoring, the sugammadex group (n = 46) received sugammadex 2 mg/kg, while the neostigmine group (n = 47) received neostigmine 0.05 mg/kg with atropine 0.02 mg/kg after at least the third twitch in response to the train of four stimulation. The primary outcome was incidence of PPCs. The secondary outcomes were duration of hospital stay and intensive care unit (ICU) admission. Results: There was no significant difference in the incidence of PPCs for both the sugammadex and neostigmine groups (32.6% and 40.4%, respectively; risk difference = 0.08; 95% confidence interval = [−0.12, 0.27]; P = 0.434). The lengths of hospital (P = 0.431) and ICU (P = 0.964) stays were not significantly different between the two groups. Conclusions The clinical use of sugammadex and neostigmine in NMB reversal for patients undergoing VATS lobectomy was not significantly different in the incidence of PPCs and duration of hospital and ICU stay.

Background: Sore throat and hoarseness frequently occur following general anesthesia with tracheal intubation and are effectively reduced when dexamethasone is used prophylactically. Alchemilla vulgaris in glycerine (Neo Mucosal Activator®) suppresses inflammatory response, possibly relieving sore throat. Methods: We enrolled 94 patients (age ≥ 18 years) scheduled for thoracic surgery using double-lumen tube intubation. Before intubation, 0.2 mg/kg of dexamethasone was administered intravenously and 2 ml of normal saline was sprayed into the oropharyngeal cavity (Group D; n = 45), or 0.04 ml/kg normal saline was administered intravenously and 1 g of Neo Mucosal Activator® mixed with 1 ml of normal saline was sprayed into the oropharyngeal cavity (Group N; n = 43), in a double blind and prospectively randomized manner. Postoperative sore throat and hoarseness were recorded using a numeral rating scale and a 4-point scale to detect a change in voice quality following tracheal extubation (at 1, 6, and 24 h). The primary outcome was the incidence of sore throat at 24 h following surgery. The secondary outcomes were incidence and severity of sore throat and hoarseness. Results: There were no significant differences in the incidence of sore throat at 24 h following surgery (57.8% vs. 46.5%; P = 0.290) or in the incidence and intensity of sore throat and hoarseness at 1, 6, and 24 h following surgery between the groups. Conclusions A. vulgaris in glycerine did not significantly differ from dexamethasone for preventing sore throat and hoarseness owing to intubation.

Objective: To investigate the association between vitamin E and handgrip strength (HGS) with multiple factors. Methods: A total of 1,814 participants were included (822 men and 981 women) from the Korean subjects of the 7th Korea National Health and Nutrition Examination Survey in 2018. Data were analyzed using multiple logistic regression to determine the correlation between vitamin E and HGS with potential confounding factors. Results: In the multiple logistic regression model, only the young age group (19–40 years) of men showed a positive relationship between vitamin E and HGS. However, in older age groups (41–80 years) of men and all age groups of women, there was no statistically significant result. After adjusting for confounding factors, young men showed higher vitamin E levels and higher HGS. Conversely, women and older age groups did not show significant results after adjusting for confounding factors. Conclusion In this study, the serum vitamin E level had a positive effect on HGS in young men (<40 years). Further research is needed on this topic regarding vitamin E intake and other objective measures.