Current Status of ‘Professional Identity Formation’ Education in the Medical Professionalism Curriculum in Korea / 의학교육논단

This study examined the current status of the medical professionalism curriculum in Korea to suggest a plan to move towards the formation of a professional identity. Professionalism education data from 28 Korean medical schools were analyzed, including the number of courses, required or elective status, corresponding credits, major course contents, and teaching and evaluation methods. Considerable variation was found in the number of courses and credits in the professionalism curriculum between medical schools.The course contents were structured to expand learners’ experiences, including the essence and knowledge of professionalism, understanding of oneself, social interaction with others, and the role of doctors in society and the healthcare system. The most common teaching methods were lectures and discussions, while reflective writing, coaching, feedback, and role models were used by fewer than 50% of medical schools. Written tests, assignments and reports, discussions, and presentations were frequently used as evaluation methods, but portfolio and self-evaluation rates were relatively low. White coat ceremonies were conducted in 96.2% of medical schools, and 22.2% had no code of conduct. Based on the above results, the author suggests that professional identity formation should be explicitly included in learning outcomes and educational contents, and that professional identity formation courses need to be added to each year of the program. The author also proposes the need to expand teaching methods such as reflective writing, feedback, dilemma discussion, and positive role models, to incorporate various evaluation methods such as portfolios, self-assessment, and moral reasoning, and to strengthen faculty development.

Sports Pharmacy: New Specialty of Pharmacists and Pharmaceutical Care Services

The World Anti-Doping Agency has made efforts to promote the safe use of medications and prevent doping in sports globally. International standards have been established and experts have advocate anti-doping education to athletes and healthcare professionals. Pharmacists are expected to participate in the pharmaceutical care activity of sports medicine in protecting the athletes while providing the spirits of clean sports. In this review, we described the pharmacists’ roles and functions in six areas of sports pharmaceutical care: awareness, treatment, prevention, optimization, abuse, and monitoring. Sports pharmacists should be able to prevent inappropriate drug use and manage athletes’ illness and injury using pharmacotherapy. Further pharmacists should actively involve to educate and counsel athletes, trainers, and healthcare teams. In conclusion, pharmacists are expected to play important roles in sports pharmacy, which is the emerging area of specialized pharmaceutical care services.

Translation to Filipino and validation of the Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire for patellar tendinopathy

BACKGROUND@#Patellar tendinopathy is an overuse injury characterized by pain on the distal part of the patella caused by specific movement patterns like jumping. To assess the severity of patellar tendinopathy, the self-administered VISA-P questionnaire was developed in the English language. The purpose of this study was to translate and cross-culturally adapt the VISA-P questionnaire into Filipino and determine its psychometric properties.@*METHODS@#A psychometric study design was used in this study. The VISA-P was translated from English to Filipino following the guidelines set by Beaton et al. and Sousa et al. There were six stages: (1) forward translation to Filipino, (2) synthesis, (3) backward translation, (4) expert committee review, (5) pilot testing/cognitive briefing, and (6) preliminary psychometric testing. The psychometric testing was conducted on eight patients with patellar tendinopathy and eight healthy subjects.@*RESULTS@#The Filipino VISA-P questionnaire (VISA-P-Fil) successfully underwent translation and cross-cultural adaptation. It exhibited excellent face, content validity (Item-Content Validity index and Scale-Content Validity Index= 1.00), construct validity (p>0.05, except for Item 6), internal consistency (Cronbach α= 0.81) as well as reliability (ICC= 0.99; 95% CI: 0.994 – 0.999; SEM= 0.42; minimum detectable change at 95% confidence level= 1.79). No ceiling and floor effects were noted for the VISA-PFil.@*CONCLUSION@#In conclusion, the VISA-P-Fil questionnaire was translated and cross-culturally adapted successfully with good validity. Preliminary testing also showed its excellent reliability.

Current Status of ‘Professional Identity Formation’ Education in the Medical Professionalism Curriculum in Korea / 의학교육논단

This study examined the current status of the medical professionalism curriculum in Korea to suggest a plan to move towards the formation of a professional identity. Professionalism education data from 28 Korean medical schools were analyzed, including the number of courses, required or elective status, corresponding credits, major course contents, and teaching and evaluation methods. Considerable variation was found in the number of courses and credits in the professionalism curriculum between medical schools.The course contents were structured to expand learners’ experiences, including the essence and knowledge of professionalism, understanding of oneself, social interaction with others, and the role of doctors in society and the healthcare system. The most common teaching methods were lectures and discussions, while reflective writing, coaching, feedback, and role models were used by fewer than 50% of medical schools. Written tests, assignments and reports, discussions, and presentations were frequently used as evaluation methods, but portfolio and self-evaluation rates were relatively low. White coat ceremonies were conducted in 96.2% of medical schools, and 22.2% had no code of conduct. Based on the above results, the author suggests that professional identity formation should be explicitly included in learning outcomes and educational contents, and that professional identity formation courses need to be added to each year of the program. The author also proposes the need to expand teaching methods such as reflective writing, feedback, dilemma discussion, and positive role models, to incorporate various evaluation methods such as portfolios, self-assessment, and moral reasoning, and to strengthen faculty development.

Sports Pharmacy: New Specialty of Pharmacists and Pharmaceutical Care Services

The World Anti-Doping Agency has made efforts to promote the safe use of medications and prevent doping in sports globally. International standards have been established and experts have advocate anti-doping education to athletes and healthcare professionals. Pharmacists are expected to participate in the pharmaceutical care activity of sports medicine in protecting the athletes while providing the spirits of clean sports. In this review, we described the pharmacists’ roles and functions in six areas of sports pharmaceutical care: awareness, treatment, prevention, optimization, abuse, and monitoring. Sports pharmacists should be able to prevent inappropriate drug use and manage athletes’ illness and injury using pharmacotherapy. Further pharmacists should actively involve to educate and counsel athletes, trainers, and healthcare teams. In conclusion, pharmacists are expected to play important roles in sports pharmacy, which is the emerging area of specialized pharmaceutical care services.

Preliminary Clinical Trial of Balance Compensation System for Improvement of Balance in Patients With Spinocerebellar Ataxia

Objective@#To determine the immediate and short-term impact of the application of wearable balance compensation system (BCS) on balance impairment in patients with spinocerebellar ataxia (SCA). @*Methods@#The study enrolled 6 participants with SCA with varying degrees of balance impairment. After adjustment for individual fitting, wearable BCS with up to 3% body weight was placed in a garment on the trunk. Sway direction and magnitude were measured with sensors placed posteriorly at the lumbosacral junction, immediately before and after, and at day 1, day 2, and day 7 after wearing the BCS. Timed Up & Go test (TUG) and 25-foot timed walk test were performed, and static foot pressure was measured. @*Results@#A significant improvement in static and dynamic balance was found during the 25-foot timed walk and in static foot pressure measurement results after wearing the BCS, when compared with that at baseline (p=0.044 vs. p=0.011). Anterior and posterior sway showed improvements from baseline after wearing the BCS. Improvement in the lateral swaying movement control was also seen. @*Conclusion@#Application of the BCS might be beneficial in the improvement ofthe static and dynamic balance in patients with SCA. Further research on long-term effects and with a larger sample size is indicated.

Phelligridin D maintains the function of periodontal ligament cells through autophagy in glucose-induced oxidative stress

Purpose@#The objective of this study was to investigate whether phelligridin D could reduce glucose-induced oxidative stress, attenuate the resulting inflammatory response, and restore the function of human periodontal ligament cells (HPDLCs). @*Methods@#Primary HPDLCs were isolated from healthy human teeth and cultured. To investigate the effect of phelligridin D on glucose-induced oxidative stress, HPDLCs were treated with phelligridin D, various concentrations of glucose, and glucose oxidase.Glucose-induced oxidative stress, inflammatory molecules, osteoblast differentiation, and mineralization of the HPDLCs were measured by hydrogen peroxide (H2O2 ) generation, cellular viability, alkaline phosphatase (ALP) activity, alizarin red staining, and western blot analyses. @*Results@#Glucose-induced oxidative stress led to increased production of H2O2 , with negative impacts on cellular viability, ALP activity, and calcium deposition in HPDLCs. Furthermore, HPDLCs under glucose-induced oxidative stress showed induction of inflammatory molecules (intercellular adhesion molecule-1, vascular cell adhesion protein-1, tumor necrosis factor-alpha, interleukin-1-beta) and disturbances of osteogenic differentiation (bone morphogenetic protein-2, and -7, runt-related transcription factor-2), cementogenesis (cementum protein-1), and autophagy-related molecules (autophagy related 5, light chain 3 I/II, beclin-1). Phelligridin D restored all these molecules and maintained the function of HPDLCs even under glucose-induced oxidative stress. @*Conclusions@#This study suggests that phelligridin D reduces the inflammation that results from glucose-induced oxidative stress and restores the function of HPDLCs (e.g., osteoblast differentiation) by upregulating autophagy.

Phelligridin D maintains the function of periodontal ligament cells through autophagy in glucose-induced oxidative stress

Purpose@#The objective of this study was to investigate whether phelligridin D could reduce glucose-induced oxidative stress, attenuate the resulting inflammatory response, and restore the function of human periodontal ligament cells (HPDLCs). @*Methods@#Primary HPDLCs were isolated from healthy human teeth and cultured. To investigate the effect of phelligridin D on glucose-induced oxidative stress, HPDLCs were treated with phelligridin D, various concentrations of glucose, and glucose oxidase.Glucose-induced oxidative stress, inflammatory molecules, osteoblast differentiation, and mineralization of the HPDLCs were measured by hydrogen peroxide (H2O2 ) generation, cellular viability, alkaline phosphatase (ALP) activity, alizarin red staining, and western blot analyses. @*Results@#Glucose-induced oxidative stress led to increased production of H2O2 , with negative impacts on cellular viability, ALP activity, and calcium deposition in HPDLCs. Furthermore, HPDLCs under glucose-induced oxidative stress showed induction of inflammatory molecules (intercellular adhesion molecule-1, vascular cell adhesion protein-1, tumor necrosis factor-alpha, interleukin-1-beta) and disturbances of osteogenic differentiation (bone morphogenetic protein-2, and -7, runt-related transcription factor-2), cementogenesis (cementum protein-1), and autophagy-related molecules (autophagy related 5, light chain 3 I/II, beclin-1). Phelligridin D restored all these molecules and maintained the function of HPDLCs even under glucose-induced oxidative stress. @*Conclusions@#This study suggests that phelligridin D reduces the inflammation that results from glucose-induced oxidative stress and restores the function of HPDLCs (e.g., osteoblast differentiation) by upregulating autophagy.

The Effects of Simulation Education for New Nurses on Emergency Management Using Low-fidelity Simulator / 한국간호교육학회지

PURPOSE: This study focuses on investigating the effectiveness of simulation education on emergency management using a low-fidelity simulator as related to clinical skill performance, self-confidence, knowledge, learning satisfaction, and critical thinking disposition in new nurses. METHODS: A pre-post test experimental design of nonequivalent control group was applied. Fifty-five new nurses were recruited, 28 nurses for the experimental group and 27 nurses for the control group. A simulation education for emergency management comprising knowledge lecture, team learning, skill education, team simulation, and debriefing was developed and implemented from Feb. 14 to 27, 2015. Data were analyzed with percentage, average, and standard deviation, chi-square, and t-test using SPSS. RESULTS: The experimental group showed significantly higher knowledge (t=5.81, p<.001), clinical skill performance (t=10.08, p<.001), self-confidence (t=-6.24, p<.001), critical thinking disposition (t=2.42, p=.019), and learning satisfaction (t=4.21, p<.001) for emergency management compared with the control group who had traditional lecture education. CONCLUSION: The results indicate that a simulation education using a low-fidelity simulator is an efficient teaching method for new nurses to deepen their clinical skill performance, self-confidence, knowledge, learning satisfaction, and critical thinking disposition in learning emergency management.

Factors Affecting the Infertility-Related Quality of Life among the Infertility Women

OBJECTIVES: The purpose of this study is to determine the infertility stress, resilience, intimacy and infertility-related quality of life of infertility women in an infertility clinic, and to reveal associated factors of infertility-related quality of life. METHODS: As a descriptive study, data was collected from 92 infertility women in an infertility clinic. Data was analyzed using t-test, analysis of variance, Pearson correlation coefficients and stepwise multiple regression. RESULTS: Infertility stress, resilience, intimacy and infertility-related quality of life averaged 3.1±0.5, 3.7±0.3, 3.3±0.3, 3.2±0.5 respectively. The infertility-related quality of life varied with a statistical significance by marital period, the presence of a burdensome person and burdensome person. Infertility-related quality of life had a negative correlation with infertility stress (r=−0.69, p<0.001), and a positive correlation with resilience (r=0.23, p=0.28) and intimacy (r=0.22, p=0.030). Meaningful variables that influenced infertility-related quality of life were ‘need for parenthood,’ ‘social concern in infertility stress’ and ‘positive factor in resilience,’ and infertility-related quality of life was explained 56.6% by the variables. CONCLUSION: It is suggested to highlight the importance of the infertility-related quality of life and to develop and execute the nursing intervention program for enhancing resilience and decreasing infertility stress of infertility women in infertility clinics.

Proper Cut-off Levels of Serum Specific IgE to Cefaclor for Patients with Cefaclor Allergy

PURPOSE: Cefaclor, a second-generation oral cephalosporin, is known to cause IgE-mediated hypersensitivity. Assays of serum-specific IgE (sIgE) to cefaclor are commercially available via the ImmunoCAP system (Thermo Fisher Scientific). While serum levels of sIgE >0.35 kU/L are considered indicative of an allergy, some patients with cefaclor allergy show low serum IgE levels. This study aimed to evaluate the proper cut-off levels of sIgE in the diagnosis of immediate hypersensitivity to cefaclor. MATERIALS AND METHODS: A total of 269 patients with drug allergy history, who underwent assays of sIgE to cefaclor at Ajou University hospital and Dong-A University Hospital, were reviewed retrospectively. Among them, 193 patients exhibited cefaclor-induced immediate hypersensitivity with certain or probable causality of an adverse drug reaction according to the WHO-UMC (the World Health Organization-the Uppsala Monitoring Centre) algorithm, and 76 controls showed delayed hypersensitivity reactions to non-antibiotics. RESULTS: In total, 126 of the 193 patients (65.3%) experienced anaphylaxis; they had higher serum sIgE levels than patients with immediate hypersensitivity who did not experience anaphylaxis (6.36±12.39 kU/L vs. 4.28±13.61 kU/L, p < 0.001). The best cut-off value for cefaclor-induced immediate hypersensitivity was 0.11 kU/L, with sensitivity of 80.2% and specificity of 81.6%. A cut-off value of 0.44 kU/L showed the best sensitivity (75.4%) and specificity (65.7%) for differentiating anaphylaxis from immediate hypersensitivity reactions. CONCLUSION: Patients with cefaclor anaphylaxis exhibit high serum IgE levels. A cut-off value of 0.11 kU/L of sIgE to cefaclor is proper for identifying patients with cefaclor allergy, and 0.44 kU/L may be useful to detect anaphylaxis.

The Effects of an Early Knee Joint Exercise Education Program on Pain, Knee Range of Motion, and Satisfaction in Patients after Undergoing Total Knee Replacement Arthroplasty / 임상간호연구

PURPOSE: This study was conducted to evaluate the effects of early knee joint exercise education program on pain, knee ROM, and satisfaction among patients with a total knee replacement arthroplasty. METHODS: An experimental study with non-equivalent groups was conducted using 32 patients for an experimental group and 32 patients for a control group. The experimental group received knee joint exercise education including systemic continuous passive motion (CPM) exercise and knee exercise. The control group received conventional CPM exercise. Pain, flexion and flexion contracture range of motion, and patient satisfaction were evaluated by χ2 test, Fisher's exact test, t-test, and repeated measures ANOVA using the SPSS 23.0 Windows program. RESULTS: There were a significant improvement in patients' knee flexion and satisfaction in the experimental group compared to the control group. There was no significant difference in pain and flexion contracture between the two groups. CONCLUSION: The findings suggest that the proposed education program is efficient and effective when providing nursing care after a total knee replacement arthroplasty.

Outbreak of Imipenemase-1-Producing Carbapenem-Resistant Klebsiella pneumoniae in an Intensive Care Unit / 대한구급학회지

BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) with acquired metallo β-lactamase (MBL) resistance have been increasingly reported worldwide and associated with significant mortality and morbidity. Here, an outbreak of genetically related strains of Klebsiella pneumoniae producing the imipenemase (IMP)-1 MBL in a medical intensive care unit (MICU) in Korea is reported. METHODS: Since isolating carbapenem-resistant K. pneumoniae (CRKP) at the MICU of the hospital on August 10, 2011, surveillance cultures for CRE in 31 hospitalized patients were performed from August to September 2011. Carbapenem resistance was determined based on the disk diffusion method outlined in the Clinical and Laboratory Standards Institute guidelines. Polymerase chain reaction (PCR) was performed for genes coding for β-lactamase. Associations among isolates were assessed via pulsed-field gel electrophoresis (PFGE). In addition, a surveillance study of environmental cultures and health-care workers (HCWs) was conducted in the MICU during the same time frame. RESULTS: During the study period, non-duplicated CRKP specimens were discovered in four patients in the MICU, suggestive of an outbreak. On August 10, 2011, CRKP was isolated from the sputum of a 79-year-old male patient who was admitted to the MICU. A surveillance study to detect additional CRE carriers by rectal swab revealed an additional three CRKP isolates. PCR and sequencing of the four isolates identified the presence of the IMP-1 gene. In addition, PFGE showed that the four isolated strains were genetically related. CRE was not identified in specimens taken from the hands of HCWs or other environmental sources during surveillance following the outbreak. Transmission of the carbapenemase-producing Enterobacteriaceae strain was controlled by isolation of the patients and strict contact precautions. CONCLUSIONS: This study shows that rapid and systemic detection of CRE and strict infection controls are important steps in preventing nosocomial transmission.

Development an instrument assessing residents' attitude towards professionalism lapses in training / 한국의학교육

PURPOSE: Medical professionalism is a fundamental competency for all physicians and continuous development of professionalism during residency training is crucial. The purpose of this study was to develop an instrument assessing residents' attitudes toward unprofessional behaviors. METHODS: A questionnaire survey was conducted in cooperation with the Korea Resident Association from May to July 2013. A total of 317 residents from seven university-affiliated hospitals in South Korea participated in the survey. RESULTS: In the exploratory factor analysis, seven factors were extracted from the data; factor loadings of the 44 items ranged between 0.40 and 0.89. Through iterative discussion, three items below 0.45 were deleted and one additional item was removed due to its irrelevance. Twelve items included in Factor 1 were divided into two different categories. A final version of the questionnaire containing 40 items in eight categories was assessed using confirmatory factor analysis. It was deemed to have a good fit; the root mean square error of approximation and comparative fit index were 0.07 and 0.9, respectively. The reliability (Cronbach's α) of the inventory was 0.97. CONCLUSION: The items of this instrument encompass a broad range of residents' behaviors in clinical practice, research, and publication. In addition, it includes some types of misconduct that can be considered unique features of the authors' cultural backgrounds. We recommend this instrument as an assessment tool to diagnose residents' perceptions and attitudes towards professionalism lapses and to provide insight regarding potential improvement in professionalism education.

Outbreak of Imipenemase-1-Producing Carbapenem-Resistant Klebsiella pneumoniae in an Intensive Care Unit / 대한중환자의학회지

BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) with acquired metallo β-lactamase (MBL) resistance have been increasingly reported worldwide and associated with significant mortality and morbidity. Here, an outbreak of genetically related strains of Klebsiella pneumoniae producing the imipenemase (IMP)-1 MBL in a medical intensive care unit (MICU) in Korea is reported. METHODS: Since isolating carbapenem-resistant K. pneumoniae (CRKP) at the MICU of the hospital on August 10, 2011, surveillance cultures for CRE in 31 hospitalized patients were performed from August to September 2011. Carbapenem resistance was determined based on the disk diffusion method outlined in the Clinical and Laboratory Standards Institute guidelines. Polymerase chain reaction (PCR) was performed for genes coding for β-lactamase. Associations among isolates were assessed via pulsed-field gel electrophoresis (PFGE). In addition, a surveillance study of environmental cultures and health-care workers (HCWs) was conducted in the MICU during the same time frame. RESULTS: During the study period, non-duplicated CRKP specimens were discovered in four patients in the MICU, suggestive of an outbreak. On August 10, 2011, CRKP was isolated from the sputum of a 79-year-old male patient who was admitted to the MICU. A surveillance study to detect additional CRE carriers by rectal swab revealed an additional three CRKP isolates. PCR and sequencing of the four isolates identified the presence of the IMP-1 gene. In addition, PFGE showed that the four isolated strains were genetically related. CRE was not identified in specimens taken from the hands of HCWs or other environmental sources during surveillance following the outbreak. Transmission of the carbapenemase-producing Enterobacteriaceae strain was controlled by isolation of the patients and strict contact precautions. CONCLUSIONS: This study shows that rapid and systemic detection of CRE and strict infection controls are important steps in preventing nosocomial transmission.

Affecting Factors of the Awareness of Biomedical Ethics in Nursing Students / 한국간호교육학회지

PURPOSE: This study was conducted to examine awareness of biomedical ethics, and to identify affecting factors of the awareness of biomedical ethics in nursing students. METHODS: The subjects consisted of 266 nursing students their third and fourth years of study. The data were collected from October to December, 2015 by self-report using questionnaires. Data analysis was performed using SPSS/WIN 18.0, descriptive statistics, t-test, ANOVA, Scheffé test, Pearson correlation coefficient, and multiple regression analysis. RESULTS: The mean score of the awareness of biomedical ethics was 2.81±0.22, perception of death was 3.15±0.36, and knowledge of brain death, organ donation, and organ transplant was 12.12±3.02. The prediction factors of awareness of biomedical ethics were gender (β=.29, p<.001), participation in religious activity (β=.23, p=.015), and perception of death (β=.20, p=.016). The explanation power was 17.1%. CONCLUSION: These results showed that education about biomedical ethics is necessary for nursing students, and the development of biomedical ethics educational programs should reflect affecting factors.

Hemodynamic Adaptations to Regular Exercise in People With Spinal Cord Injury

OBJECTIVE: To investigate the real-time cardiovascular response to the progressive overload exercise in different levels of spinal cord injury (SCI), and to find out whether regular exercise has effect on these cardiovascular responses. METHODS: The study enrolled 8 able-bodied individuals in the control group plus 15 SCI subjects who were divided into two groups by their neurological level of injury: high-level SCI group (T6 or above) and low-level SCI group (T7 or below). Also, subjects were divided into exercise group and non-exercise group by usual exercise habits. We instructed the subjects to perform exercises using arm ergometer according to the protocol and checked plethysmograph for the real time assessment of blood pressure, heart rate, and cardiac output. RESULTS: Six subjects were included in high-level SCI group (3 cervical, 3 thoracic injuries), 9 subjects in low-level SCI group (9 thoracic injuries), and 8 able-bodied individuals in control group. During arm ergometer-graded exercise, mean arterial pressure (MAP) was significantly lower in high-level SCI subjects of non-exercise group, compared with high-level SCI subjects of exercise group. In addition, HR was significantly higher in low-level SCI group compared with control group. CONCLUSION: There are significant differences in mean arterial pressure of high-level SCI group according to usual exercise habits. We discovered that even in non-athlete high-level SCI, regular exercise can bring cardiac modulation through blood pressure control.

Vanilloid Receptor 1 Agonists, Capsaicin and Resiniferatoxin, Enhance MHC Class I-restricted Viral Antigen Presentation in Virus-infected Dendritic Cells

DCs, like the sensory neurons, express vanilloid receptor 1 (VR1). Here we demonstrate that the VR1 agonists, capsaicin (CP) and resiniferatoxin (RTX), enhance antiviral CTL responses by increasing MHC class I-restricted viral antigen presentation in dendritic cells (DCs). Bone marrow-derived DCs (BM-DCs) were infected with a recombinant vaccinia virus (VV) expressing OVA (VV-OVA), and then treated with CP or RTX. Both CP and RTX increased MHC class I-restricted presentation of virus-encoded endogenous OVA in BM-DCs. Oral administration of CP or RTX significantly increased MHC class I-restricted OVA presentation by splenic and lymph node DCs in VV-OVA-infected mice, as assessed by directly measuring OVA peptide SIINFEKL-Kb complexes on the cell surface and by performing functional assays using OVA-specific CD8 T cells. Accordingly, oral administration of CP or RTX elicited potent OVA-specific CTL activity in VV-OVA-infected mice. The results from this study demonstrate that VR1 agonists enhance anti-viral CTL responses, as well as a neuro-immune connection in anti-viral immune responses.

Effect of Regular Exercise on Cardiopulmonary Fitness in Males With Spinal Cord Injury

OBJECTIVE: To evaluate the cardiopulmonary endurance of subjects with spinal cord injury by measuring the maximal oxygen consumption with varying degrees of spinal cord injury level, age, and regular exercise. METHODS: We instructed the subjects to perform exercises using arm ergometer on healthy adults at 20 years of age or older with spinal cord injury, and their maximal oxygen consumption (VO2max) was measured with a metabolic measurement system. The exercise proceeded stepwise according to the exercise protocol and was stopped when the subject was exhausted or when VO2 reached an equilibriu RESULTS: Among the 40 subjects, there were 10 subjects with cervical cord injury, 27 with thoracic cord injury, and 3 with lumbar cord injury. Twenty-five subjects who were exercised regularly showed statistically higher results of VO2max than those who did not exercise regularly. Subjects with cervical injury showed statistically lower VO2max than the subjects with thoracic or lumbar injury out of the 40 subjects with neurologic injury. In addition, higher age showed a statistically lower VO2max. Lastly, the regularly exercising paraplegic group showed higher VO2max than the non-exercising paraplegic group. CONCLUSION: There are differences in VO2max of subjects with spinal cord injury according to the degree of neurologic injury, age, and whether the subject participates in regular exercise. We found that regular exercise increased the VO2max in individuals with spinal cord injury.

Pain-Related Evoked Potential in Healthy Adults

OBJECTIVE: To investigate the normal data of pain-related evoked potentials (PREP) elicited with a concentric surface electrode among normal, healthy adults and the relationship between PREP and pain intensity. METHODS: Sixty healthy volunteers (22 men and 38 women; aged 36.4+/-10.7 years; height, 165.4+/-7.8 cm) were enrolled. Routine nerve conduction study (NCS) was done to measure PREP following electrical stimulation of hands (C7 dermatome) and feet (L5 dermatome). Negative peak (N), positive peak (P) latencies, peak to peak (NP) amplitudes, conduction velocity (CV), and verbal rating scale (VRS) score were obtained. Linear regression analysis tested for significant relevance between variables of PREP and VRS score. RESULTS: Normal NCS results were obtained in all subjects. N latency of hand PREP was 163.8 +/-40.0 ms (right) and 161.0+/-39.9 ms (left). N latency of foot PREP was 178.0+/-43.9 ms (right), 180.4+/-43.4 ms (left). NP amplitude of hands was 20.6+/-10.6 microV (right) and 21.9+/-11.6 microV (left). NP amplitude of feet was 18.8+/-8.3 microV (right) and 19.0+/-8.4 microV (left). The calculated CV was 13.2+/-4.7 m/s and VRS score was 3.8+/-1.0. A highly significant positive correlation was evident between VRS score and NP amplitude (y=0.1069x+1.781, r=0.877, n=60, p<0.0001). CONCLUSION: PREP among normal, healthy adults revealed a statistically significant correlation between PREP amplitude and VRS score.