Changes in Language Function and Recovery-Related Prognostic Factors in First-Ever Left Hemispheric Ischemic Stroke

OBJECTIVE: To investigate longitudinal changes in language function in left-hemispheric ischemic stroke patients as well as factors that influence language recovery until 1 year after stroke onset.METHODS: We analyzed data from 235 patients with first-ever left-hemispheric ischemic stroke. All patients completed the Korean version of the Frenchay Aphasia Screening Test (K-FAST) at 7 days (T1), 3 months (T2), 6 months (T3), and 1 year (T4) after stroke onset. Repeated measures analysis of variance (ANOVA) was used to investigate changes in language function between time points. Subgroup analysis was performed according to the K-FAST scores at T1. Stroke lesion volume was assessed using diffusion tensor images, and involvement of language-related brain regions was examined. Multiple regression analysis was used to analyze factors influencing improvement of K-FAST score.RESULTS: The K-FAST scores at T1, T2, T3, and T4 differed significantly (p < 0.05). In the subgroup analysis, only the severe group showed continuous significant improvement by 1 year. Factors that negatively influenced improvement of language function were the age at onset, initial National Institutes of Health Stroke Scale (NIHSS) score, and initial K-FAST score, whereas education level and stroke lesion volume positively affected recovery. Involvement of language-related brain regions did not significantly influence long-term language recovery after ischemic stroke.CONCLUSION: Recovery of language function varied according to the severity of the initial language deficit. The age at stroke onset, education level, initial severity of aphasia, initial NIHSS score, and total stroke lesion volume were found to be important factors for recovery of language function.

Coexistence of expanding abdominal aortic aneurysm and aggravated intervertebral disc extrusion: a case report / 대한마취과학회지

Abdominal aortic aneurysm is included in the differential diagnosis of lower back pain. Although rare, this important disease can cause potentially lethal complications. In this case, expanding abdominal aortic aneurysm coexisted with intervertebral disc extrusion. The diagnosis of abdominal aortic aneurysm was delayed, putting the patient at risk of aneurysmal rupture. In the management of patients with degenerative spinal diseases, we should not overlook the possibility of comorbidities such as an abdominal aortic aneurysm. We also suggest the importance of interpreting images more carefully, especially for elderly male patients.

Death below 2 g/dL of Hemoglobin Concentrations: As an Independent Predictor of Death

Fifty three years old, healthy female patient had presented an acute severe anemia after intestinal bleeding within 2 days. She was hemodynamically stable even during extreme hemodilution with hemoglobin (Hb) below 3 g/dL. However, her condition deteriorated dramatically after Hb nearly 2 g/dL. The patient died solely of anemia at a hemoglobin concentration of 1.2 g/dL. We presumed the hemoglobin concentrations below 2 g/dL are maximally life-threatening; this is the terminal hemoglobin threshold that the hemoglobin concentration could be an independent predictor of death.

Assessing the Prevalence of Recurrent Neck and Shoulder Pain in Korean High School Male Students: A Cross-sectional Observational Study

BACKGROUND: Neck and shoulder pain (NSP) is fairly common in adolescents, which is associated with a high prevalence of NSP found during adulthood as well; therefore, its significance during adolescence should not be underestimated. We surveyed the prevalence of recurrent NSP, lifestyle, and risk factors in Korean high school students, and examined the influence of recurrent NSP on the quality of life. METHODS: Nine hundred thirty one male students (16-19 years old) from two academic high schools in Seoul were included in this study. The survey consisted of a questionnaire to assess the prevalence of recurrent NSP, with questions regarding having an occurrence more than once a week, characteristics of NSP, activity and lifestyle of the students, and the risk factors for recurrent NSP. A 36-item Short Form questionnaire was also examined. RESULTS: We found that 44.3% of the high school students surveyed had recurrent NSP (more than once a week) and the overall prevalence of NSP was 79.1%. The average sitting time was 10.2 +/- 2.7 h/day. 59.0% did not sit straight, 14.7% used assisting devices during reading, and 11.9% answered that they stretched regularly. Found from their self assessed health, frequent fatigue and frequent depressed mood presented significant associations with the higher prevalence of recurrent NSP. CONCLUSIONS: Korean high school students had a high prevalence of recurrent NSP. Clinical attention is needed for the prevention and resolution of recurrent NSP found in high school students.

Prevention of TNF-induced necrotic cell death by rottlerin through a Nox1 NADPH oxidase

Previous studies have demonstrated that rottlerin, a specific PKCdelta inhibitor, potentiates death receptor- mediated apoptosis through a cytochrome c-dependent or -independent pathway. However, its ability to regulate necrotic cell death, as well as the underlying mechanism, remains unknown. We found that in murine fibrosarcoma L929 cells, treatment with rottlerin protected the cells against TNF-induced necrosis, whereas it sensitized the cells to apoptosis induced by co-treatment with Hsp90 inhibitor geldanamycin and TNF, in a manner independent of its ability to inhibit PKC-delta. TNF treatment induced rapid accumulation of mitochondrial superoxide (O2") through the Nox1 NADPH oxidase when cells undergo necrosis. Moreover, pretreatment with rottlerin failed to induce the GTP-bound form of small GTPase Rac1 by TNF treatment, and subsequently suppressed mitochondrial O2(-) production and poly(ADP-ribose) polymerase activation, thus inhibiting necrotic cell death. Therefore, our study suggests that Nox1 NADPH oxidase is a new molecular target for anti-necrotic activity of rottlerin upon death-receptor ligation.

The Prevalence and Related Risk Factors of Prehypertension among Local Residents Aged 45 or Over in Chuncheon City: The Hallym Aging Study (A Community-Based Cross-Sectional Study)

BACKGROUND AND OBJECTIVES: The purpose of this study is to determine the prevalence of prehypertension (preHT) among the local residents aged 45 or over, and to compare the differences in demographic factors, anthropometric measurements, life style factors and metabolic profiles between the normotensive (nBP) and preHT individuals. SUBJECTS AND METHODS: The study data was based on the Hallym Aging Study that included 855 adults (356 men and 499 women) aged 45 years or over who lived in Chuncheon city. PreHT was defined by the JNC-7 criteria. We examined the life styles (alcohol, smoking and exercise) of the subjects and we measured the obesity indices. The metabolic profiles are fasting blood glucose (FBS), cholesterol, triglyceride (TG) and HDL-C. The association between preHT and the related factors was examined by using multiple logistic regression analysis. RESULTS: The age-adjusted overall prevalence of preHT is 32.4% (33.6% in men, 31.6% in women). The obesity indices are significantly higher in the preHT group (waist circumference, WC: 87.1+/-8.5 vs 83.3+/-9.3 cm, respectively, p=0.000, waist-hip ratio: 0.93+/-6.6 vs 0.90+/-7.7, respectively, p=0.004, and body mass index: 25.1+/-3.3 vs 23.8+/-3.3 kg/m2, respectively, p=0.001) compared with the nBP group. The metabolic profiles are significantly different for the FBS of the preHT and nBP groups (104.6+/-29.8 vs 96.9+/-21.1 mg/dL, respectively, p=0.005) and TG (160.3+/-82.8 vs 133.4+/-65.3 mg/dL, respectively, p=0.001). The preHT group has more Framingham risk factors and metabolic syndrome components (p=0.003) than the group with a nBP. Important determinants of preHT are a WC> or = 90 cm (OR: 6.28) and a TG> or = 150 mg/dL (OR: 4.33) for men and a BMI> or = 27 kg/m2 (OR: 3.82), a FBS> or =100 mg/dL (OR: 3.05) and a TG> or = 150 mg/dL (OR: 2.69) for women. CONCLUSION: In this study, the preHT group shows a collection of multiple risk factors, including obesity, hyperlipidemia and fasting glucose abnormalities. Early recognition and more intensive life style modification are needed to reduce the risk of cardiovascular disease.

The Prevalence and Risk Factors of the Metabolic Syndrome among Local Residents Aged 45 or over in Chuncheon: Hallym Aging Study

BACKGROUND: To estimate the prevalence of the metabolic syndrome in Chuncheon city in those ages 45 and over and to evaluate the association between risk factors and the risk of the metabolic syndrome. METHODS: The subject of this study included 662 adults (males 276, females 386) aged 45 years or over who lived in Chuncheon city. The metabolic syndrome was defined as having 3 or more conditions inclnding abdominal obesity, high blood pressure, low HDL cholesterol, high triglyceride, and high fasting glucose. The association between the metabolic syndrome and its life-style related factors, such as smoking, exercise, and drinking, was examined, using multiple logistic regression. RESULTS: The prevalence of the metabolic syndrome from ATP III criteria was 30.1% in men, and 37.9% in women. The prevalence increased with age in women. In men, however, the prevalence increased to 55~64 age group and then it gradually decreased. The prevalence of the metabolic syndrome from Asia-Pacific criteria was 48.2% in men, and 46.6% in women. The prevalence increased with age in men and decreased in women. The highest prevalence among the individual components of diagnostic criteria of the metabolic syndrome in men was hypertension, followed by abdominal obesity, hypertriglyceridemia, low HDL-cholesterolemia, and high fasting blood glucose. And in women, it was abdominal obesity, followed by hypertension, low HDL cholesterolemia, hypertriglyceridemia, and high fasting blood glucose. After adjusting for potential covariates, current smoker was 1.93 times at a greater risk for the metabolic syndrome than non-smokers (95% confidence interval 1.06~3.51). CONCLUSION: The prevalence of the metabolic syndrome was higher than previously reported in Korea. Further studies are strongly needed to elucidate the factors which are related to the syndrome and to develop effective prevention guidelines, especially among the elderly.

Experimental evaluation of pathogenicity of Lactococcus garvieae in black rockfish (Sebastes schlegeli)

Black rockfish (Sebastes schlegeli) is an important mariculture species in Korea. The production of this fish is drastically declined due to bacterial diseases, particularly streptococcosis caused by Lactococcus garvieae. The bacterial surface characteristics of SJ7 and TY6 were found to have capsule but not NB13 and YS18. The experiential evaluation of L. garvieae pathogenicity, the capsular isolates showed high cumulative mortality i.e. SJ7 (100%) and TY6 (60%) compared to non-capsular isolates. Based on this result the capsular isolates L. garvieae were highly suspected as the causative agent of streptococcosis in rockfish.