Objective: To identify the prevalence and factors associated with T-score discordance between the spine and hip, as well as between the paretic and non-paretic hips in hemiplegic stroke patients, this study investigated bone mineral density (BMD) patterns. Bone loss predominantly affects the paretic hip after a stroke, and typical clinical assessments using dual-energy X-ray absorptiometry (DXA) that scan the lumbar spine (LS) and a single hip may overlook an osteoporosis diagnosis. This oversight could potentially lead to suboptimal treatment for stroke patients. Methods: This study was a multicenter retrospective analysis of 540 patients admitted for stroke rehabilitation between October 2014 and February 2022, who underwent DXA of LS and bilateral hips. Results: The prevalence rates of concordance, low LS discordance, and low hip discordance between the LS and hips were 48.2%, 12.2%, and 39.6%, respectively. The discordance rate between bilateral hips was 17.0%. The paretic side had significantly lower total hip T-scores than the non-paretic side (p<0.001). Notably low paretic hip discordance was more prevalent during the chronic phase. DXA scans of the LS and both hips revealed a 0.7%–0.9% higher major discordance compared to LS and single hip DXA scans. The multivariate analysis revealed a significant correlation between a low paretic hip discordance and cognitive impairment (adjusted odds ratio 0.071, 95% confidence interval 0.931–1.003, p<0.05). Conclusion Since stroke survivors are at high risk for hip fractures, comprehensive BMD assessments, which include LS and bilateral hips, should be considered for post-stroke osteoporosis care to enhance diagnostic accuracy and timely treatment.

Objective: To identify the prevalence and factors associated with T-score discordance between the spine and hip, as well as between the paretic and non-paretic hips in hemiplegic stroke patients, this study investigated bone mineral density (BMD) patterns. Bone loss predominantly affects the paretic hip after a stroke, and typical clinical assessments using dual-energy X-ray absorptiometry (DXA) that scan the lumbar spine (LS) and a single hip may overlook an osteoporosis diagnosis. This oversight could potentially lead to suboptimal treatment for stroke patients. Methods: This study was a multicenter retrospective analysis of 540 patients admitted for stroke rehabilitation between October 2014 and February 2022, who underwent DXA of LS and bilateral hips. Results: The prevalence rates of concordance, low LS discordance, and low hip discordance between the LS and hips were 48.2%, 12.2%, and 39.6%, respectively. The discordance rate between bilateral hips was 17.0%. The paretic side had significantly lower total hip T-scores than the non-paretic side (p<0.001). Notably low paretic hip discordance was more prevalent during the chronic phase. DXA scans of the LS and both hips revealed a 0.7%–0.9% higher major discordance compared to LS and single hip DXA scans. The multivariate analysis revealed a significant correlation between a low paretic hip discordance and cognitive impairment (adjusted odds ratio 0.071, 95% confidence interval 0.931–1.003, p<0.05). Conclusion Since stroke survivors are at high risk for hip fractures, comprehensive BMD assessments, which include LS and bilateral hips, should be considered for post-stroke osteoporosis care to enhance diagnostic accuracy and timely treatment.

Objective: To identify the prevalence and factors associated with T-score discordance between the spine and hip, as well as between the paretic and non-paretic hips in hemiplegic stroke patients, this study investigated bone mineral density (BMD) patterns. Bone loss predominantly affects the paretic hip after a stroke, and typical clinical assessments using dual-energy X-ray absorptiometry (DXA) that scan the lumbar spine (LS) and a single hip may overlook an osteoporosis diagnosis. This oversight could potentially lead to suboptimal treatment for stroke patients. Methods: This study was a multicenter retrospective analysis of 540 patients admitted for stroke rehabilitation between October 2014 and February 2022, who underwent DXA of LS and bilateral hips. Results: The prevalence rates of concordance, low LS discordance, and low hip discordance between the LS and hips were 48.2%, 12.2%, and 39.6%, respectively. The discordance rate between bilateral hips was 17.0%. The paretic side had significantly lower total hip T-scores than the non-paretic side (p<0.001). Notably low paretic hip discordance was more prevalent during the chronic phase. DXA scans of the LS and both hips revealed a 0.7%–0.9% higher major discordance compared to LS and single hip DXA scans. The multivariate analysis revealed a significant correlation between a low paretic hip discordance and cognitive impairment (adjusted odds ratio 0.071, 95% confidence interval 0.931–1.003, p<0.05). Conclusion Since stroke survivors are at high risk for hip fractures, comprehensive BMD assessments, which include LS and bilateral hips, should be considered for post-stroke osteoporosis care to enhance diagnostic accuracy and timely treatment.

Purpose: This prospective, single-center, open-label, therapeutic confirmatory, randomized clinical trial aimed to assess the alleviation of anal pain by applying structured anal skin care including skin protectants in rectal cancer patients with low anterior resection syndrome (LARS) combined with anal pain. Methods: From December 2017 to May 2020, 42 patients with LARS (scores of ≥21) and anal pain (visual analogue scale [VAS] score of ≥3) were randomly assigned and observed for 4 weeks. The conventional treatment consisted of dietary management, sitz baths, prohibition of anal scrubbing, loperamide, and dioctahedral smectite. In the anal care group, cleanser, barrier cream, and barrier spray were applied to the anal skin after defecation following the conventional treatment. The primary outcome was analgesic effect on anal pain after 2 weeks of structured treatment (anal care group) or conventional (control group). The cutoff for analgesic effect was a decrease in the anal pain score (VAS score of ≥2 or ≥30% reduction). Results: As a primary outcome, the analgesic effect was significantly higher in the anal care group (P = 0.034). The incontinence-associated dermatitis skin condition score was significantly improved in the anal care group than control group after 4 weeks (P = 0.023). There were no significant differences in LARS scores and quality of life scores between 2 groups. Conclusion Structured anal skin care has a significant analgesic effect in reducing anal pain and improving anal skin conditions in patients with LARS after rectal cancer surgery.

Purpose: Patients who undergo radical surgery for rectal cancer often experience low anterior resection syndrome (LARS). Symptoms of this syndrome include frequent bowel movements, gas incontinence, fecal incontinence, fragmentation, and urgency. The aim of this study was to investigate the convergent validity, discriminative validity, and reliability of the Korean version of the LARS score questionnaire. Methods: The English LARS score questionnaire was translated into Korean using the forward-and-back translation method. A total of 146 patients who underwent radical surgery for rectal cancer answered the Korean version of the LARS score questionnaire including an anchor question assessing the impact of bowel function. Participants answered the questionnaire once more after 2 weeks. Results: The Korean LARS score questionnaire showed high convergent validity in terms of high correlation between the LARS score and quality of life (perfect fit 55.5% vs. moderate fit 37.6% vs. no fit 6.8%, respectively; P < 0.001). The LARS score also showed good discriminative validity between groups of patients differing by sex (29 for males vs. 25 for females; P = 0.014), tumor level (29 for ≤8 cm vs. 24 for >8 cm; P = 0.021), and radiotherapy (32 for yes vs. 24 for no; P = 0.001). The LARS score also demonstrated high reliability at test-retest with no difference between scores at the first and second tests (intraclass correlation coefficient: Q1 = 0.932; Q2 = 0.909, Q3 = 0.944, Q4 = 0.931, and Q5 = 0.942; P < 0.001, respectively). Conclusion The Korean version of the LARS score questionnaire has proven to be a valid and reliable tool for measuring LARS in Korean patients with rectal cancer.

alpha-Asarone exhibits a number of pharmacological actions including neuroprotective, anti-oxidative, anticonvulsive, and cognitive enhancing action. The present study investigated the effects of alpha-asarone on pro-inflammatory cytokines mRNA, microglial activation, and neuronal damage in the hippocampus and on learning and memory deficits in systemic lipopolysaccharide (LPS)-treated C57BL/6 mice. Varying doses of alpha-asarone was orally administered (7.5, 15, or 30 mg/kg) once a day for 3 days before the LPS (3 mg/kg) injection. alpha-Asarone significantly reduced TNF-alpha and IL-1beta mRNA at 4 and 24 hours after the LPS injection at dose of 30 mg/kg. At 24 hours after the LPS injection, the loss of CA1 neurons, the increase of TUNEL-labeled cells, and the up-regulation of BACE1 expression in the hippocampus were attenuated by 30 mg/kg of alpha-asarone treatment. alpha-Asarone significantly reduced Iba1 protein expression in the hippocampal tissue at a dose of 30 mg/kg. alpha-Asarone did not reduce the number of Iba1-expressing microglia on immunohistochemistry but the average cell size and percentage areas of Iba1-expressing microglia in the hippocampus were significantly decreased by 30 mg/kg of alpha-asarone treatment. In the Morris water maze test, alpha-asarone significantly prolonged the swimming time spent in the target and peri-target zones. alpha-Asarone also significantly increased the number of target heading and memory score in the Morris water maze. The results suggest that inhibition of pro-inflammatory cytokines and microglial activation in the hippocampus by alpha-asarone may be one of the mechanisms for the alpha-asarone-mediated ameliorating effect on memory deficits.
Animals ; Cell Size ; Cytokines* ; Head ; Hippocampus ; Immunohistochemistry ; Learning ; Maze Learning ; Memory ; Memory Disorders* ; Mice* ; Microglia ; Neurons ; RNA, Messenger ; Swimming ; Tumor Necrosis Factor-alpha ; Up-Regulation

alpha-Asarone exhibits a number of pharmacological actions including neuroprotective, anti-oxidative, anticonvulsive, and cognitive enhancing action. The present study investigated the effects of alpha-asarone on pro-inflammatory cytokines mRNA, microglial activation, and neuronal damage in the hippocampus and on learning and memory deficits in systemic lipopolysaccharide (LPS)-treated C57BL/6 mice. Varying doses of alpha-asarone was orally administered (7.5, 15, or 30 mg/kg) once a day for 3 days before the LPS (3 mg/kg) injection. alpha-Asarone significantly reduced TNF-alpha and IL-1beta mRNA at 4 and 24 hours after the LPS injection at dose of 30 mg/kg. At 24 hours after the LPS injection, the loss of CA1 neurons, the increase of TUNEL-labeled cells, and the up-regulation of BACE1 expression in the hippocampus were attenuated by 30 mg/kg of alpha-asarone treatment. alpha-Asarone significantly reduced Iba1 protein expression in the hippocampal tissue at a dose of 30 mg/kg. alpha-Asarone did not reduce the number of Iba1-expressing microglia on immunohistochemistry but the average cell size and percentage areas of Iba1-expressing microglia in the hippocampus were significantly decreased by 30 mg/kg of alpha-asarone treatment. In the Morris water maze test, alpha-asarone significantly prolonged the swimming time spent in the target and peri-target zones. alpha-Asarone also significantly increased the number of target heading and memory score in the Morris water maze. The results suggest that inhibition of pro-inflammatory cytokines and microglial activation in the hippocampus by alpha-asarone may be one of the mechanisms for the alpha-asarone-mediated ameliorating effect on memory deficits.
Animals ; Cell Size ; Cytokines* ; Head ; Hippocampus ; Immunohistochemistry ; Learning ; Maze Learning ; Memory ; Memory Disorders* ; Mice* ; Microglia ; Neurons ; RNA, Messenger ; Swimming ; Tumor Necrosis Factor-alpha ; Up-Regulation

PURPOSE: Peripheral arterial disease (PAD) is an increasing health problem, as we progress towards an aging society. The diseases known as risk factors of PAD are diabetes mellitus (DM), hypertension, and dyslipidemia, and PAD occurs consistently in patients with diabetes. The patients with PAD do not receive proper treatment at the proper moment, because PAD is almost asymptomatic, and most of the diagnosis is delayed. We aimed to determine the prevalence, risk factors and co-morbidities of PAD in patients who are managed for DM and hypertension in our referral center. METHODS: Patients with diabetes and hypertension were selected from the Gachon University Gil Hospital. Data of the patients, including demographics and presence of risk factors, were collected using an interviewer-administered questionnaire. For PAD of the low limbs, the ankle-brachial index (ABI) was used, and the PAD of low limbs was defined as <0.9 ABI. For carotid artery stenosis (CAS), carotid duplex ultrasound was analyzed, and CAS was defined as > or =50% internal CAS. RESULTS: Logistic regression analysis showed that old age (>70) and diabetes were independent risk factors of PAD. As the risk factor number increased, the prevalence of PAD became higher. CONCLUSION: The prevalence of PAD is continuously increasing. Old age and diabetes were independently associated with a high risk of all-cause PAD patients. For timely and proper management of PAD, large-scale research is needed. Based on research, we should make a detailed plan about early screening, and treatment of PAD.
Aging ; Ankle Brachial Index ; Carotid Stenosis ; Demography ; Diabetes Mellitus ; Dyslipidemias ; Extremities ; Humans ; Hypertension ; Logistic Models ; Mass Screening ; Peripheral Arterial Disease ; Prevalence ; Surveys and Questionnaires ; Referral and Consultation ; Risk Factors

Tuberous sclerosis is an autosomal dominant disorder characterized by facial skin lesions, epilepsy, and mental retardation. Pulmonary involvement in tuberous sclerosis is rare and shows characteristic reticulonodular infiltration and cystic changes. Lymphangioleiomyomatosis is characterized by the progressive proliferation of smooth muscle cells and occurs in 0.1-1% of patients with tuberous sclerosis. We encountered a case of pulmonary lymphangioleiomyomatosis associated with tuberous sclerosis and bilateral renal angiomyolipoma in a 31-year-old female patient. This case is reported here along with a brief review of the literature.
Adult ; Angiomyolipoma ; Epilepsy ; Female ; Humans ; Intellectual Disability ; Lymphangioleiomyomatosis ; Myocytes, Smooth Muscle ; Skin ; Tuberous Sclerosis

Tuberous sclerosis is an autosomal dominant disorder characterized by facial skin lesions, epilepsy, and mental retardation. Pulmonary involvement in tuberous sclerosis is rare and shows characteristic reticulonodular infiltration and cystic changes. Lymphangioleiomyomatosis is characterized by the progressive proliferation of smooth muscle cells and occurs in 0.1-1% of patients with tuberous sclerosis. We encountered a case of pulmonary lymphangioleiomyomatosis associated with tuberous sclerosis and bilateral renal angiomyolipoma in a 31-year-old female patient. This case is reported here along with a brief review of the literature.
Adult ; Angiomyolipoma ; Epilepsy ; Female ; Humans ; Intellectual Disability ; Lymphangioleiomyomatosis ; Myocytes, Smooth Muscle ; Skin ; Tuberous Sclerosis