Objective: Epinephrine is a first-line drug for anaphylaxis, but a poor prognosis can occur if not administered properly. This study compared the clinical features of patients with anaphylaxis in the emergency department (ED) according to epinephrine administration. Methods: This was a retrospective cross-sectional study using ED-based data retrieved from a tertiary university hospital. Patients diagnosed with anaphylaxis between 2018 and 2020 were enrolled in this study. The patients with anaphylaxis were classified according to epinephrine administration, and the clinical features were compared. The adjusted odds ratios (AORs) with a 95% confidence interval (CI) were calculated for the main factors associated with epinephrine use. Results: Among 205 eligible patients with anaphylaxis, 157 (76.6%) were treated with epinephrine. The main contributing factors influencing epinephrine use were patients with cardiovascular symptoms (AOR=2.97; 95% CI, 1.26-7.01) and patients transferred from other hospitals (AOR=0.37; 95% CI, 0.16-0.85). Conclusion The major factors influencing epinephrine use in the ED when patients with anaphylaxis presented with cardiovascular symptoms were identified. It is essential to prevent potentially fatal consequences in patients with anaphylaxis through appropriate epinephrine administration.

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.

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.

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.

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.

The aim of this study was to evaluate and compare the reorganization of corticospinal pathways innervating upper extremity muscles in patients with spastic hemiplegic cerebral palsy (CP). Thirty-2 patients (17 male, 15 female) with spastic hemiplegic CP were enrolled. The average age (mean ± standard deviation) was 7.5 ± 4.6 (range: 2–17) years. Transcranial magnetic stimulation (TMS) was applied to the unaffected and affected motor cortices in turn, and bilateral electromyographic recordings were made from the first dorsal interossei (FDI), the biceps brachii (BB), and the deltoid muscles during rest. The onset latency, central motor conduction time, and peak-to-peak amplitude of motor evoked potentials (MEPs) were measured for each muscle bilaterally. Whilst TMS of both affected and unaffected hemispheres elicited contralateral MEPs in all muscles, the number of MEPs evoked from the affected hemisphere was less than from the unaffected hemisphere for FDI and BB. TMS responses to stimulation of the affected side showed prolonged latency and reduced amplitude. The amplitudes of MEPs increased with age whereas the latencies were relatively constant. These results suggest that the corticospinal pathways to the proximal and distal muscles of the upper extremity undergo sequential maturation and reorganization patterns.
Cerebral Palsy ; Child ; Deltoid Muscle ; Evoked Potentials, Motor ; Humans ; Male ; Muscle Spasticity ; Muscles ; Pyramidal Tracts ; Transcranial Magnetic Stimulation ; Upper Extremity

PURPOSE: The prognostic significance of tumor-infiltrating lymphocytes (TILs) has been determined in breast cancers. Interferons can affect T-cell activity through direct and indirect mechanisms. Myxovirus resistance A (MxA) is an excellent marker of interferon activity. Here,we evaluated TILs and MxA expression in human epidermal growth factor receptor 2 (HER2)–positive breast cancers. MATERIALS AND METHODS: Ninety cases of hormone receptor (HR)+/HER2+ tumors and 78 cases of HR–/HER2+ tumors were included. The TILs level was assessed using hematoxylin and eosin–stained full face sections, and MxA expressionwas evaluated by immunohistochemistrywith a tissue microarray. RESULTS: MxA protein expression was significantly higher in tumors with high histologic grade (p=0.023) and high levels of TILs (p=0.002). High levels of TILs were correlated with high histological grade (p=0.001), negative lymphovascular invasion (p=0.007), negative lymph node metastasis (p=0.007), absence of HR expression (p < 0.001), abundant tertiary lymphoid structures (TLSs) around ductal carcinoma in situ (p=0.018), and abundant TLSs around the invasive component (p < 0.001). High levels of TILs were also associated with improved disease-free survival, particularly in HR–/HER2+ breast cancers. However, MxA was not a prognostic factor. CONCLUSION: High expression of MxA in tumor cells was associated with high levels of TILs in HER2-positive breast cancers. Additionally, a high level of TILs was a prognostic factor for breast cancer, whereas the level of MxA expression had no prognostic value.
Breast Neoplasms ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Disease-Free Survival ; Epidermal Growth Factor* ; Hematoxylin ; Humans* ; Interferons ; Lymph Nodes ; Lymphocytes, Tumor-Infiltrating* ; Myxovirus Resistance Proteins ; Neoplasm Metastasis ; Orthomyxoviridae* ; Receptor, Epidermal Growth Factor* ; T-Lymphocytes