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Objective@#Chronic low back pain (LBP) is a huge social burden, and optimal exercise therapies for chronic LBP patients are continuously being studied. To evaluate the effects of digital intervention on pain and disability in patients with chronic LBP, we performed a prospective cohort study. Method: From February 2020 to January 2021, 25 patients with chronic LBP were recruited. Digital intervention contains education contents and video demonstration for individually prescribed exercise. The exercise prescription was renewed every 4 weeks according to subjects’ condition and accomplishment of exercise. This intervention was performed for more than 30 weeks. The pain intensity was assessed using a numeric rating scale (NRS) while their degree of disability was assessed using the Roland-Morris Disability Questionnaire (RMDQ). The pain intensity and disability was evaluated at short term (8∼20 weeks) and long term (30 weeks). @*Results@#As a result, pain intensity (NRS) decreased significantly over the short term and long term (p<0.05). However, pain related disability (RMDQ score) did not change significantly over the follow-up period (p=0.554). @*Conclusion@#Our findings indicate that online-based digital intervention reduced the intensity of chronic LBP. Further research is needed to identify methods to cost-effectively and consistently manage chronic LBP.
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Low back pain (LBP) is a common musculoskeletal disorder such that 70∼85% of people experience LBP at least once in their lifetime. With advances in Internet and mobile technology, digital intervention for LBP has emerged as a new treatment method that allows patients to actively participate in treatment at home using digital devices. Several studies on digital interventions have reported improvements in pain by up to 68%, on disability scales by up to 55%, and also in other significant areas such as quality of life and psychological well-being. In particular, mobile application-based treatment was effective, and treatment including exercise therapy had a distinct effect. Also, studies have shown that interactions between healthcare provider and patient, and immediate audiovisual feedback following analysis of the patients’ motions can enhance the therapeutic effect. Evidence-based digital care for patients with LBP is an effective method of treatment and is expected to advance further in the future.
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Background@#There are many models for predicting diabetes mellitus (DM), but their clinical implication remains vague. Therefore, we aimed to create various DM prediction models using easily accessible health screening test parameters. @*Methods@#Two sets of variables were used to develop eight DM prediction models. One set comprised 62 easily accessible examination results of commonly used variables from a tertiary university hospital. The second set comprised 27 of the 62 variables included in the national routine health checkups. Gradient boosting and random forest algorithms were used to develop the models. Internal validation was performed using the stratified 10-fold cross-validation method. @*Results@#The area under the receiver operating characteristic curve (ROC-AUC) for the 62-variable DM model making 12-month predictions for subjects without diabetes was the largest (0.928) among those of the eight DM prediction models. The ROC-AUC dropped by more than 0.04 when training with the simplified 27-variable set but still showed fairly good performance with ROC-AUCs between 0.842 and 0.880. The accuracy was up to 11.5% higher (from 0.807 to 0.714) when fasting glucose was included. @*Conclusion@#We created easily applicable diabetes prediction models that deliver good performance using parameters commonly assessed during tertiary university hospital and national routine health checkups. We plan to perform prospective external validation, hoping that the developed DM prediction models will be widely used in clinical practice.
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Objectives@#Clozapine is the most effective atypical antipsychotic agent for the treatment-resistant schizophrenia (TRS), however, only 40%–70% of TRS patients respond to clozapine. Moreover, TRS encompasses various symptom dimensions. Therefore, augmentation with other medications for clozapine is frequently applied. However, the prescription pattern of clozapine and combined medications in Korea is yet to be examined. This study aims to investigate the maintenance treatment pattern of clozapine and augmentation agents in one Korean tertiary hospital. @*Methods@#The patients with schizophrenia spectrum disorders under clozapine maintenance, defined as one-year clozapine continuation, were subjected for analysis. Medication data at one-year time-point after clozapine initiation was extracted and analyzed. @*Results@#Among total 2897 patients having clozapine prescription experience from January 2000 to December 2018, 1011 patients were on clozapine maintenance. The mean age of clozapine initiation was 30.2 ± 11.3 years, and the maintenance dose of clozapine was 217.8 ± 124.3 mg/day. Combination rate of antipsychotics, mood stabilizers, and antidepressants were 43.5%, 25.3%, 38.6%, respectively. Most frequently prescribed drugs in each category were aripiprazole, valproate, and sertraline. Olanzapine equivalent dose of combined antipsychotics was 10.4 ± 7.7 mg/day. Male patients were prescribed higher dose of combined antipsychotics and higher rate of antidepressants. Female patients had later onset of clozapine prescription. Patients with two or more combined antipsychotics were prescribed higher dose of clozapine and higher rate of antidepressants compared to patients with one combined antipsychotic. @*Conclusions@#Taken together, among the patients taking clozapine, a substantial rate of patients were under polypharmacy. The present findings based on the real-world prescription pattern could provide the valuable clinical information on the treatment of TRSrelated conditions.
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Objectives@#The purpose of this study was to investigate the association between the Basic Old-Age Pension (BOP), which is a noncontributory pension, and depression in BOP beneficiaries in Korea. @*Methods@#We used the second and third waves (2007-2008) of the Korea Welfare Panel Study to identify the effect of the BOP on mental health in the year of its introduction. The Center for Epidemiological Studies-Depression Scale, applied in a Korean context, was used to evaluate mental health. To analyze the effect of the BOP, a difference-in-difference approach was used in analyses of all subjects and subgroups. @*Results@#For this study population of 760 adults, the BOP did not have a statistically significant relationship with depression in its beneficiaries. After controlling for type of household, the BOP was still not associated with lower reporting of depression, either in singlebeneficiary or double-beneficiary households, in the year of the benefit. @*Conclusions@#The BOP policy had no significant relationship with the level of depression among recipients. However, this should not be interpreted as implying that income subsidy programs for older adults, such as the BOP, do not affect mental health, considering the importance of economic hardship in this population and the program’s socioeconomic effects.
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Patient-derived xenograft (PDX) mouse models are frequently used to test the drug efficacy in diverse types of cancer. They are known to recapitulate the patient characteristics faithfully, but a systematic survey with a large number of cases is yet missing in lung cancer. Here we report the comparison of genomic characters between mouse and patient tumor tissues in lung cancer based on exome sequencing data. We established PDX mouse models for 132 lung cancer patients and performed whole exome sequencing for trio samples of tumor-normal-xenograft tissues. Then we computed the somatic mutations and copy number variations, which were used to compare the PDX and patient tumor tissues. Genomic and histological conclusions for validity of PDX models agreed in most cases, but we observed eight (~7%) discordant cases. We further examined the changes in mutations and copy number alterations in PDX model production and passage processes, which highlighted the clonal evolution in PDX mouse models. Our study shows that the genomic characterization plays complementary roles to the histological examination in cancer studies utilizing PDX mouse models.
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Patient-derived xenograft (PDX) mouse models are frequently used to test the drug efficacy in diverse types of cancer. They are known to recapitulate the patient characteristics faithfully, but a systematic survey with a large number of cases is yet missing in lung cancer. Here we report the comparison of genomic characters between mouse and patient tumor tissues in lung cancer based on exome sequencing data. We established PDX mouse models for 132 lung cancer patients and performed whole exome sequencing for trio samples of tumor-normal-xenograft tissues. Then we computed the somatic mutations and copy number variations, which were used to compare the PDX and patient tumor tissues. Genomic and histological conclusions for validity of PDX models agreed in most cases, but we observed eight (~7%) discordant cases. We further examined the changes in mutations and copy number alterations in PDX model production and passage processes, which highlighted the clonal evolution in PDX mouse models. Our study shows that the genomic characterization plays complementary roles to the histological examination in cancer studies utilizing PDX mouse models.
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OBJECTIVE: This study evaluated the feasibility of ultrasound-guided lumbar nerve root block (LNRB) and S1 nerve root block by identifying spread patterns via fluoroscopy in cadavers.METHOD: A total of 48 ultrasound-guided injections were performed in 4 fresh cadavers from L1 to S1 roots. The target point of LNRB was the midpoint between the lower border of the transverse process and the facet joint at each level. The target point of S1 nerve root block was the S1 foramen, which can be visualized between the median sacral crest and the posterior superior iliac spine, below the L5-S1 facet joint. The injection was performed via an in-plane approach under real-time axial view ultrasound guidance. Fluoroscopic validation was performed after the injection of 2 cc of contrast agent.RESULTS: The needle placements were correct in all injections. Fluoroscopy confirmed an intra-foraminal contrast spreading pattern following 41 of the 48 injections (85.4%). The other 7 injections (14.6%) yielded typical neurograms, but also resulted in extra-foraminal patterns that occurred evenly in each nerve root, including S1.CONCLUSION: Ultrasound-guided injection may be an option for the delivery of injectate into the S1 nerve root, as well as lumbar nerve root area.
Subject(s)
Cadaver , Fluoroscopy , Injections, Spinal , Lumbosacral Region , Methods , Needles , Spinal Nerve Roots , Spine , Ultrasonography , Zygapophyseal JointABSTRACT
PURPOSE: Surface finishing of a zirconia restoration is essential after clinical adjustment. Herein, we investigated the effects of a surface finishing protocol for monolithic zirconia on final roughness and bacterial adherence. MATERIALS AND METHODS: Forty-eight disk-shaped monolithic zirconia specimens were fabricated and divided into four groups (n = 12) based on initial surface treatment, finishing, and polishing protocols: diamond bur+polishing bur (DP group), diamond bur+stone grinding bur+polishing bur (DSP group), no diamond bur+polishing bur (NP group), and no diamond bur+stone grinding bur+polishing bur (NSP group). Initial and final surface roughness was measured with a profilometer, and shown using scanning electron microscope. Bacterial adhesion was evaluated by quantifying Streptococcus mutans in the biofilm. Kruskal-Wallis and Mann-Whitney U tests were used to compare results among groups, and two-way analysis of variance was used to evaluate the effects of grinding burs on final roughness (α=.05). RESULTS: The DP group had the highest final Ra value, followed by the DSP, NP, and NSP groups. Use of the stone grinding bur as a coarse-finishing step significantly decreased final Ra values when a diamond bur was used (P < .001). Omission of the stone grinding bur increased biofilm formation on specimen surfaces. Combining a stone grinding bur with silicone polishing burs produced the smallest final biofilm values, regardless of the use of a diamond bur in initial surface treatment. CONCLUSION: Coarse finishing of monolithic zirconia with a stone grinding bur significantly decreased final Ra values and bacterial biofilm formation when surfaces had been roughened by a diamond bur.
Subject(s)
Bacterial Adhesion , Biofilms , Dental Instruments , Dental Polishing , Diamond , Silicon , Silicones , Streptococcus mutansABSTRACT
PURPOSE: The present study was designed to examine the clinical fit of fixed dental prosthesis fabricated by the milling-sintering method using a presintered cobalt-chromium alloy. MATERIALS AND METHODS: Two single metal-ceramic crowns were fabricated via milling-sintering method and casting method in each of the twelve consecutive patients who required an implant-supported fixed prosthesis. In the milling-sintering method, the prosthetic coping was designed in computer software, and the design was converted to a non-precious alloy coping using milling and post-sintering process. In the casting method, the conventional manual fabrication process was applied. The absolute marginal discrepancy of the prostheses was evaluated intraorally using the triple-scan technique. Statistical analysis was conducted using Mann-Whitney U test (α=.05). RESULTS: Eight patients (66.7%) showed a lower marginal discrepancy of the prostheses made using the milling-sintering method than that of the prosthesis made by the casting method. Statistically, the misfit of the prosthesis fabricated using the milling-sintering method was not significantly different from that fabricated using the casting method (P=.782). There was no tendency between the amount of marginal discrepancy and the measurement point. CONCLUSION: The overall marginal fit of prosthesis fabricated by milling-sintering using a presintered alloy was comparable to that of the prosthesis fabricated by the conventional casting method in clinical use.
Subject(s)
Humans , Alloys , Clinical Study , Crowns , Dental Prosthesis , Methods , Prostheses and ImplantsABSTRACT
Huntington's disease is a neurodegenerative disorder with an autosomal dominant inheritance pattern. Patients with Huntington's disease show an increased risk of aspiration pneumonia when the pharyngeal muscle is invaded. We report a case of advanced-stage Huntington's disease in which the patient received right middle lobectomy for a lung abscess caused by repeated aspiration. The best lung isolation technique has not yet been established in these patients. We successfully performed selective lobar isolation of the right lower and middle lobes using a double lumen tube and a Fogarty embolectomy catheter.