The frequencies of disease entities that cause acute abdominal pain in end-stage renal disease: focused on differences between hemodialysis and peritoneal dialysis patients

Objective@#The aim of this study was to investigate the frequency of disease entities that cause abdominal pain in endstage renal disease (ESRD) patients who visited an emergency department (ED) and to compare differences in diagnoses between hemodialysis (HD) and peritoneal dialysis (PD) patients. @*Methods@#This retrospective observational study included 179 ESRD patients over the age of 18 years who visited an ED with abdominal pain from January 2013 to December 2018. All electronic medical record data were collected and reviewed by a single physician. @*Results@#The most common pathologies regardless of dialysis methods were peritonitis (n=51, 28.5%), nonspecific abdominal pain (NSAP; n=30, 16.8%), acute gastroenteritis (AGE; n=16, 8.9%), gastritis (n=16, 8.9%), and cholecystitis/biliary colic (n=11, 6.1%). In HD patients, the most common diseases were NSAP (n=25, 22.7%), AGE (n=15, 13.6%), gastritis (n=13, 11.8%), and cholecystitis/biliary colic (n=11, 10.0%). In PD patients, peritonitis (n=47, 68.1%), NSAP (n=5, 7.2%), kidney rupture (n=4, 5.8%), and gastritis (n=3, 4.3%) were the most common. The statistically significant disease entities between the two groups were peritonitis (HD: n=4, 4.6%; PD: n=47, 68.1%; P<0.001), cholecystitis/biliary colic (HD: n=11, 10.0%; PD: n=0, 0%; P=0.007), NSAP (HD: n=22, 22.7%; PD: n=5, 7.2%; P=0.007), and AGE (HD:n=15, 13.6%; PD: n=1, 1.4%; P=0.006). @*Conclusion@#In PD patients, peritonitis was the most common disease entity, whereas in HD patients, cholecystitis was relatively more common. Except for these two disease entities, the pathologies between the two groups were similar, with NSAP and AGE being the most common.

A Bibliometric Analysis Using Alternative Metrics for Articles in the Annals of Rehabilitation Medicine

Objective@#To investigate the articles in the Annals of Rehabilitation Medicine (ARM) using a bibliometric analysis to verify whether there is a correlation between the topics of interest for expert groups and the public media. @*Methods@#A total of 1,088 ARM articles from the third issue of 2011 to the third issue of 2019 were analyzed. We conducted a bibliometric analysis of the articles using conventional metrics (CM) and alternative metrics (AM). The CM was investigated by collating the type of publication, number of citations, and the specific field of rehabilitation medicine for each article. The AM was analyzed using the Altmetric Attention Score (AAS) provided by Altmetric, the leading AM company. The correlation between the number of citations and the AAS was tested using the Spearman rank correlation coefficient. @*Results@#The combined ratio of original articles and case reports was over 90% in this study; however, the total distribution was significantly different compared to previous bibliometric studies (p<0.05). There were 233 articles that satisfied both conditions of at least one citation and at least one AAS point. The number of citations and the AAS were found to have a statistically significant positive linear correlation on a scatter plot (r=0.216, p=0.001). @*Conclusion@#There is a significant correlation between AM and CM, which means itis important to increase the dissemination of academic knowledge through the public media and increase the status of the journal by increasing the citation-related index.

Correlation of the Korean Version of Falls Efficacy Scale-International With Quantitative Balance and Gait Parameters Through Exercise Program in Elderly Men

OBJECTIVE: To determine correlation of the Korean version of Falls Efficacy Scale-International (KFES-I) with other gait and balance parameters through exercise program in older men. METHODS: Between July 2015 and April 2018, 50 men of 103 participants in an exercise program for preventing falls who aged over 60 years, completed the evaluation before and after the program, had fear of falling (FOF), and could walk independently as an outpatient were enrolled retrospectively. The program comprised lower extremities and core muscle strengthening exercises following stretching exercises twice a week for 8 weeks. FOF using the KFES-I, Berg Balance Scale (BBS), Modified Barthel Index (MBI), stair up and gait categories in MBI (MBI-gait), and Timed Up and Go test (TUG) were evaluated. Quantitative gait and balance parameters were measured by gait analysis, posturography, and isokinetic dynamometer. They were compared before and after the program. Moreover, correlations of KFES-I with other parameters were examined. RESULTS: Fifty participants were enrolled. After the program, significant improvements were noted in right stride length (p=0.013) in gait analysis, MBI (p=0.012), BBS (p<0.000), TUG test (p<0.000), and KFES-I (p<0.000) scores. KFES-I was significantly correlated with MBI (r=-0.35, p=0.013), and MBI-gait (r=-0.341, p=0.015). CONCLUSION: Risk of falls could be significantly improved through exercise. KFES-I had significant correlations with MBI-gait parameters. Participants showed increases in gait and balancing ability on quantitative measurements through exercises. Therefore, regular stretching, strengthening, and balancing exercises may help prevent falls in older people.

Effective Site for the Application of Extracorporeal Shock-Wave Therapy on Spasticity in Chronic Stroke: Muscle Belly or Myotendinous Junction

OBJECTIVE: To compare the effect of extracorporeal shock-wave therapy (ESWT) applied at the muscle belly and myotendinous junction on spasticity in the upper and lower limbs of chronic stroke patients. METHODS: Of the 151 patients, a total of 80 patients with stroke-induced spasticity on the elbow flexor and 44 patients on the knee flexor were enrolled for a prospective, randomized clinical trial. The patients were divided into control, muscle belly, and myotendinous junction groups, and a total of three ESWT sessions (0.068–0.093 mJ/mm², 1,500 shots) were conducted at one per week. A Modified Ashworth Scale (MAS) and Modified Tardieu Scale (MTS) were collected at the baseline and at 1 week after each session. RESULTS: After interventions, the MAS and MTS of both the belly and the junction groups showed positive effects from the ESWT on spasticity in the elbow and knee flexors, but the control group did not. The results also tended to improve after each session until the entire intervention was completed. However, there was no significant difference between the belly and junction groups. CONCLUSION: ESWT could be effective for treating chronic spasticity after stroke when applied to muscle belly or myotendinous junction.

Assessment of Oropharyngeal Dysphagia in Patients With Parkinson Disease: Use of Ultrasonography

OBJECTIVE: To compare tongue thickness, the shortest hyoid-thyroid approximation (distance between the hyoid bone and thyroid cartilage), and the time interval between the initiation of tongue movement and the time of the shortest hyoid-thyroid approximation, by using ultrasonography in healthy controls and patients with Parkinson disease (PD). METHODS: Healthy controls and PD patients with dysphagia were compared. Ultrasonography was performed 3 times for the evaluation of tongue thickness, the shortest hyoid-thyroid approximation, and the time between the initiation of tongue movement and the shortest hyoid-thyroid approximation. RESULTS: A total of 24 healthy controls and 24 PD patients with dysphagia were enrolled. No significant differences were demonstrated between the two groups for the shortest hyoid-thyroid approximation (controls, 1.19±0.34 cm; PD patients, 1.37±0.5 cm; p=0.15) and tongue thickness (controls, 4.42±0.46 cm; PD patients, 4.27±0.51 cm; p=0.3). In contrast, the time to the shortest hyoid-thyroid approximation was significantly different between the two groups (controls, 1.53±0.87 ms; PD patients, 2.4±1.4 ms, p=0.048). CONCLUSION: Ultrasonography can be useful in evaluating dysphagia in patients with PD by direct visualization and measurement of the hyoid bone. Moreover, ultrasonography might contribute to a greater understanding of the pathophysiology of dysphagia in PD.

The Different Effect of VEGF Polymorphisms on the Prognosis of Non-Small Cell Lung Cancer according to Tumor Histology

Vascular endothelial growth factor (VEGF) contributes to tumor angiogenesis. The role of VEGF single nucleotide polymorphisms (SNPs) in lung cancer susceptibility and its prognosis remains inconclusive and controversial. This study was performed to investigate whether VEGF polymorphisms affect survival outcomes of patients with early stage non-small cell lung cancer (NSCLC) after surgery. Three potentially functional VEGF SNPs (rs833061T>C, rs2010963G>C, and rs3025039C>T) were genotyped. A total of 782 NSCLC patients who were treated with surgical resection were enrolled. The association of the SNPs with overall survival (OS) and disease free survival (DFS) was analyzed. In overall population, none of the three polymorphisms were significantly associated with OS or DFS. However, when the patients were stratified by tumor histology, squamous cell carcinoma (SCC) and adenocarcinoma (AC) had significantly different OS (Adjusted hazard ratio [aHR] = 0.76, 95% CI = 0.56–1.03 in SCC; aHR = 1.33, 95% CI = 0.98–1.82 in AC; P for heterogeneity = 0.01) and DFS (aHR = 0.75, 95% CI = 0.58–0.97 in SCC; aHR = 1.26, 95% CI = 1.00–1.60 in AC; P for heterogeneity = 0.004) according to the rs833061T>C genotypes. Our results suggest that the prognostic role of VEGF rs833061T>C may differ depending on tumor histology.

Correlation between Ultrasonography Findings and Electrodiagnostic Severity in Carpal Tunnel Syndrome: 3D Ultrasonography

BACKGROUND AND PURPOSE: To determine the correlation between the cross-sectional area (CSA) of the median nerve measured at the wrist using three-dimensional (3D) ultrasonography (US) and the electrophysiological severity of carpal tunnel syndrome (CTS). METHODS: We prospectively examined 102 wrists of 51 patients with clinical CTS, which were classified into 3 groups according to the electrodiagnostic (EDX) findings. Median nerve CSAs were measured using 3D US at the carpal tunnel inlet and at the level of maximal swelling. RESULTS: Ten wrists were negative for CTS. Of the 92 CTS-positive wrists, 23, 30, and 39 were classified as having mild, moderate, and severe CTS, respectively. The median nerve CSA differed significantly between the severe- and moderate-CTS groups (p=0.0007 at the carpal tunnel inlet and p<0.0001 at the maximal swelling site). There was a correlation between median nerve CSA and EDX parameters among those wrists with severe and mild CTS (p<0.0001 at both sites). CONCLUSIONS: The median nerve CSA as measured by 3D US could provide additional information about the severity of CTS, as indicated by the strong correlation with standard EDX findings.

Incidence and Characteristics of Acute Endophthalmitis Associated With Intravitreal Injection

PURPOSE: To evaluate the incidence, causative organism, clinical features, and visual outcomes of acute endophthalmitis following intravitreal injection. METHODS: For all intravitreal triamcinolone acetonide, bevacizumab, and lucentis injections performed in our outpatient clinic between January 2006 and June 2008, the number of injections, indications, type of administered drugs, and method of injection were investigated. The medical records of the patients with acute endoththalmitis were reviewed retrospectively. RESULTS: The total number of intravitreal injections was 10,153. The incidence of acute endophthalmitis for all intravitreal injections was 0.020% (2/10,153) with 0.030% (1/3,383) for the triamcinolone acetonide, 0.015% (1/6,552) for the bevacizumab, and 0.000% (0/218) for the ranibizumab drug injections. Streptococcus species were confirmed in the bacterial culture of two eyes with acute endotphthalmitis. After early vitrectomy and intravitreal antibiotics injection, one eye maintained vision but the other eye developed phthisis. CONCLUSIONS: Although the incidence of acute endophthalmitis following intravitreal injections performed in outpatient clinics is very low, due to the potentially fatal visual outcome after endophthalmitis, careful attention to aseptic injection technique is mandatory.

Neurotrophins and IGFs Attenuated Haloperidol-Induced Neuronal Apoptosis in Mouse Cortical Cell Cultures / 신경정신의학

OBJECTIVES: We examined the effects of neurotrophins and insulin-like growth factors on cell death induced by haloperidol, a typical anti-psychotic agent. METHOD: Neocortices from 14- or 15-daysold fetal mice for neuron-glia co-cultures were used for this experiment. RESULT: Twenty-four hours treatment of mouse cortical cell cultures with 30 M haloperidol-induced wide spread neuronal apoptosis characterized by cell body shrinkage, DNA fragmentation and condensation. Concurrent treatment with growth factors, BDNF, NT4/5, IGF-I and IGF-II, protect the neurons from the haloperidol-induced neuronal apoptosis(HINA) in a dose dependent manner(10-100ng/ml). CONCLUSION: The present study suggests the possibility that haloperidol toxicity can be hampered with growth factors. Further study about the mechanism underlying the protective capacity of the growth factors on HINA may lead to the development of the new protective strategy for tardive dyskinesia.

6-hydroxydopamine Induces Neuronal Apoptosis in Mouse Cortical Cell Cultures / 신경정신의학

OBJECTIVES: We examined the patterns of cell death induced by the 6-hydroxydopamine, a selective dopaminergic toxin that used to produce Parkinson's disease model. METHOD: Neocortices from 14- or 15-day-old fetal mice for neuron-glia co-cultures were used for this experiments. RESULTS: Cortical cell cultures exposed to 10-100 microM 6-hydroxydopamine for 24 hr under-went neuronal death without injuring glia. The degenerating neurons showed hallmark of apoptosis featuring cell body shrinkage, nuclear chromatin condensation and aggregation, nuclear membrane disintegration with intact plasma membrane, and prominent internucle- osomal DNA fragmentation. Neither the glutamate antagonists (10 microM MK-801 and 50 microM CNQX) nor antioxidants (trolox, 100 microM, N-acetyl-cysteine, 100 microM) prevented the 6-OHDA induced neuronal injury. The death was attenuated by addition of two different anti-apoptotic agents, 1 microgram/ml cycloheximide and caspase inhibitor (100 microM zVAD-fmk). CONCLUSION: These features suggest that 6-OHDA induced apoptotic type of neuronal death in cortical neuronal culture. Considering the protective effect of caspase inhibitors, a mechanism involving caspase cascade rather than oxidative stress is responsible for the 6-OHDA-induced neuronal apoptosis. In addition, our results showed that 6-OHDA-induced apoptosis is not confined to dopaminergic neurons and the primary cortical culture system so this system is suitable for the study of 6-OHDA-induced neuronal apoptosis.