Stroke Impact Scale 3.0: Reliability and Validity Evaluation of the Korean Version

OBJECTIVE: To establish the reliability and validity the Korean version of the Stroke Impact Scale (K-SIS) 3.0. METHODS: A total of 70 post-stroke patients were enrolled. All subjects were evaluated for general characteristics, Mini-Mental State Examination (MMSE), the National Institutes of Health Stroke Scale (NIHSS), Modified Barthel Index, Hospital Anxiety and Depression Scale (HADS). The SF-36 and K-SIS 3.0 assessed their health-related quality of life. Statistical analysis after evaluation, determined the reliability and validity of the K-SIS 3.0. RESULTS: A total of 70 patients (mean age, 54.97 years) participated in this study. Internal consistency of the SIS 3.0 (Cronbach's alpha) was obtained, and all domains had good co-efficiency, with threshold above 0.70. Test-retest reliability of SIS 3.0 required correlation (Spearman's rho) of the same domain scores obtained on the first and second assessments. Results were above 0.5, with the exception of social participation and mobility. Concurrent validity of K-SIS 3.0 was assessed using the SF-36, and other scales with the same or similar domains. Each domain of K-SIS 3.0 had a positive correlation with corresponding similar domain of SF-36 and other scales (HADS, MMSE, and NIHSS). CONCLUSION: The newly developed K-SIS 3.0 showed high inter-intra reliability and test-retest reliabilities, together with high concurrent validity with the original and various other scales, for patients with stroke. K-SIS 3.0 can therefore be used for stroke patients, to assess their health-related quality of life and treatment efficacy.

An Infantile Case of Sandhoff Disease Presenting With Swallowing Difficulty

Infants with Sandhoff disease typically appear normal until 3–6 months of age. As the disease progresses, they present with symptoms such as loss of motor skills, exaggerated startle response to loud noise, seizures, visual loss, and paralysis. We encountered a rare case of a 22-month-old girl with Sandhoff disease characterized by progressive motor weakness and dysphagia, who initially showed signs of aspiration at 20 months of age. The major problems related to dysphagia were oromotor dysfunction and abnormal feeding posture. Within 3 months of identification of difficulty in swallowing, the patient showed a significant decrease in food intake, with rapid deterioration of nutritional status. We report our case with a review of the literature.

Postoperative renal function in patients is unaltered after robotic-assisted radical prostatectomy / 대한마취과학회지

BACKGROUND: Pneumoperitoneum with an intra-abdominal pressure (IAP) of 14 mmHg is known to decrease renal function. Robotic-assisted radical prostatectomy (RARP) requires an IAP of more than 15 mmHg for operation. Therefore, we retrospectively investigated whether patients who underwent RARP experienced renal insufficiency during the postoperative period (at postoperative days 7 and 30). METHODS: One hundred patients who underwent RARP were enrolled in this study. Preoperative serum blood urea nitrogen (BUN) and serum creatinine (Cr) levels were measured. Creatinine clearance (CrCl) was calculated using the Cockcroft and Gault formula. CrCl was calculated at 1 day before surgery (baseline), 2 hr postoperatively, and at 1, 3, 7, and 30 days postoperatively (POD 1, POD 3, POP 7, and POD 30). Patients were assigned to abnormal CrCl (n = 52) or normal CrCl groups (n = 48) on the basis of these measurements. RESULTS: Significant inter-group differences in BUN, Cr, and CrCl were observed at all postoperative time points. BUN and Cr decreased significantly at postoperative 2 hr and POD 1, 3, and 7 versus baseline in both groups, whereas CrCl increased significantly at postoperative 2 hr and POD 1, 3, and 7 versus baseline in both groups. However, BUN, Cr, and CrCl were similar at POD 30 and preoperatively in the two groups. CONCLUSIONS: RAPR, which requires an IAP of 15-20 mmHg for more than 4 hr, does not induce renal dysfunction during the postoperative period, and even in those patients with an abnormal CrCl.

Routine Perioperative Antibiotic Prophylaxis in Renal Transplantation: It Makes No Difference for Bacterial Infections / 대한이식학회지

BACKGROUND: Although it has been a popular practice to use preventative antibiotics for the kidney recipients, it could increase the cost, encourage the growth of resistant micro-organism and have adverse effects. There has been no reported concrete evidence about the benefits and risks of using peri-operative prophylactic antibiotics for an immunosuppressed population. Therefore, we retrospectively evaluated the differences in the incidences of bacterial infection and adverse events after transplant surgery according to using peri-operative prophylactic antibiotics. METHODS: We reviewed retrospectively 106 cases of renal transplantations (cadaver donor: 42 cases, living donor: 64 cases) that were performed at Ajou University Hospital, Korea from January, 2006 to December, 2008. We divided the cases into two groups: Group A (n=41; 38.7%) included the patients who did not receive prophylactic antibiotics and Group B (n= 65; 61.3%) included the patients who did receive prophylactic antibiotics. We analyzed the infectious complications that occurred within 1 month after renal transplantation. RESULTS: In Group A, most patients (62 cases, 95.3%) used a 1st generation cephalosporin. The incidence of wound infection after kidney transplant for the 65 patients who received prophylactic antibiotics was 1.5%, compared to 2.5% for the 41 patients who did not receive prophylactic antibiotics. CONCLUSIONS: This retrospective study could not demonstrate a statistically significant difference in the rates of infectious complications between the two groups, although renal transplantation is considered to be a clean-contaminated surgery. But in order to obtain a definite conclusion, we need a bigger cohort in a prospective study.