20 results on '"Kim AR"'
Search Results
2. A Question Answering Chatbot for Gastric Cancer Patients After Curative Gastrectomy: Development and Evaluation of User Experience and Performance.
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Kim AR and Park HA
- Abstract
Postoperative gastric cancer patients have many questions about managing their daily lives with various symptoms and discomfort. This study aimed to develop a knowledge-based question answering (QA) chatbot for their self-management and to evaluate the user experience and performance of the chatbot. To support the chatbot's natural language processing, we analyzed QA texts from an online self-help group, clinical guidelines, and refined frequently asked questions related to gastric cancer. We developed a named entity classification with seven superconcepts, 4544 subconcepts, and 1415 synonyms. We also developed a knowledge base by linking the users' classified question intents with the experts' answers and knowledge resources, including 677 question intents and scripts with standard QA pairs and similar question phrases. A chatbot called "GastricFAQ" was built, reflecting the question topics of the named entity classification and QA pairs of the knowledge base. User experience evaluation (N = 56) revealed the highest mean score for usefulness (4.41/5.00), with all other items rated 4.00 or higher, except desirability (3.85/5.00). The chatbot's accuracy, precision, recall, and F score ratings were 85.2%, 87.6%, 96.8%, and 92.0%, respectively, with immediate answers. GastricFAQ could be provided as one option to obtain immediate information with relatively high accuracy for postoperative gastric cancer patients., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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3. A Microlearning-Based Self-directed Learning Chatbot on Medication Administration for New Nurses: A Feasibility Study.
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Kim AR, Park AY, Song S, Hong JH, and Kim K
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- Humans, Female, Adult, Surveys and Questionnaires, Male, Self-Directed Learning as Topic, Clinical Competence, Feasibility Studies
- Abstract
New nurses must acquire accurate knowledge of medication administration, as it directly affects patient safety. This study aimed to develop a microlearning-based self-directed learning chatbot on medication administration for novice nurses. Furthermore, the study had the objective of evaluating the chatbot feasibility. The chatbot covered two main topics: medication administration processes and drug-specific management, along with 21 subtopics. Fifty-eight newly hired nurses on standby were asked to use the chatbot over a 2-week period. Moreover, we evaluated the chatbot's feasibility through a survey that gauged changes in their confidence in medication administration knowledge, intrinsic learning motivation, satisfaction with the chatbot's learning content, and usability. After using the chatbot, participants' confidence in medication administration knowledge significantly improved in all topics ( P < .001) except "Understanding a concept of 5Right" ( P = .077). Their intrinsic learning motivation, satisfaction with the learning content, and usability scored above 5 out of 7 in all subdomains, except for pressure/tension (mean, 2.12; median, 1.90). They scored highest on ease of learning (mean, 6.69; median, 7.00). A microlearning-based chatbot can help new nurses improve their knowledge of medication administration through self-directed learning., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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4. Prognosis of Venoarterial Extracorporeal Membrane Oxygenation in Mixed, Cardiogenic and Septic Shock.
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Kim AR, Hyun J, Lee SE, Hong JA, Kang PJ, Jung SH, and Kim MS
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- Humans, Stroke Volume, Ventricular Function, Left, Prognosis, Shock, Cardiogenic, Retrospective Studies, Extracorporeal Membrane Oxygenation adverse effects, Shock, Septic therapy
- Abstract
Mixed cardiogenic-septic shock (MS), defined as the combination of cardiogenic (CS) and septic (SS) shock, is often encountered in cardiac intensive care units. Herein, the authors compared the impact of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in MS, CS, and SS. Of 1,023 patients who received VA-ECMO from January 2012 to February 2020 at a single center, 211 with pulmonary embolism, hypovolemic shock, aortic dissection, and unknown causes of shock were excluded. The remaining 812 patients were grouped based on the cause of shock at VA-ECMO application: i) MS (n = 246, 30.3%), ii) CS (n = 466, 57.4%), iii) SS (n = 100, 12.3%). The MS group was younger and had lower left ventricular ejection fraction than the CS or SS group did. The 30 day and 1 year mortalities were the highest in SS (30 day mortality: 50.4% vs. 43.3% vs. 69.0%, p < 0.001 for MS versus CS versus SS, respectively; 1 year mortality: 67.5% vs. 53.2% vs. 81.0%, p < 0.001 for MS versus CS versus SS, respectively). Posthoc analysis showed that the 30 day mortality of MS was not different from CS, while the 1 year mortality of MS was worse than CS but better than SS. Venoarterial extracorporeal membrane oxygenation application for MS may help improve survival and should therefore be considered if indicated., Competing Interests: Disclosure: The authors have no conflicts of interest to report., (Copyright © ASAIO 2023.)
- Published
- 2023
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5. Effect of computerized cognitive rehabilitation in comparison between young and old age after traumatic brain injury.
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Kim SH, Gwak DW, Jeong JG, Jung H, Min YS, Kim AR, and Jung TD
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- Age Factors, Humans, Mental Status and Dementia Tests, Neuropsychological Tests, Quality of Life, Treatment Outcome, Brain Injuries, Traumatic complications, Brain Injuries, Traumatic psychology, Cognitive Dysfunction etiology, Cognitive Dysfunction rehabilitation, Therapy, Computer-Assisted
- Abstract
Introduction: Cognitive dysfunction reduces patients' quality of life and social participation with traumatic brain injury (TBI). Computerized cognitive rehabilitation is increasingly being used for cognitive therapy in TBI patients. The purpose of this study was to investigate the influence of age on the effect of computerized cognitive rehabilitation in cognitive dysfunction after TBI., Material and Methods: A total of 34 patients with cognitive dysfunction after TBI were enrolled. Participants performed 30 sessions of computerized cognitive rehabilitation (Comcog) for 6 weeks. A cognitive evaluation was performed before and after treatment with Mini-Mental State Examination (MMSE) and Computerized Neurophyschologic Test (CNT)., Results: There were no cognitive tests that differed between the young group and the old group at baseline. However, after computerized cognitive rehabilitation, the young group showed significant improvement compared to the old group in verbal memory, visual memory, attention, and visuo-motor coordination tests. The young group showed improvement in MMSE, verbal and visual memory, and visuo-motor coordination tests after computerized cognitive rehabilitation. In contrast, the old group showed significant improvement only in MMSE and visual learning test, one of the visual memory tests., Conclusion: Our findings demonstrate that age may be an important factor related to the effect of computer cognitive rehabilitation on cognitive dysfunction after TBI. Methodologically more ordered studies with larger sample sizes are needed in the future., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2022
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6. Effectiveness and safety of acupotomy on lumbar spinal stenosis: A pragmatic randomized, controlled, pilot clinical trial: A study protocol.
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Han JH, Lee HJ, Woo SH, Park YK, Choi GY, Heo ES, Kim JS, Lee JH, Park CA, Lee WD, Yang CS, Kim AR, and Han CH
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- Acupuncture Therapy methods, Humans, Pain Measurement, Pragmatic Clinical Trials as Topic, Randomized Controlled Trials as Topic, Treatment Outcome, Acupuncture Therapy adverse effects, Spinal Stenosis therapy
- Abstract
Introduction: Lumbar spinal stenosis (LSS) is a pathological condition that causes a variety of neurological symptoms due to narrowing of the anatomical structures; usually, conservative treatment is recommended, rather than surgical treatment. Acupotomy combines conventional acupuncture with small scalpels; the procedure can be considered minimally invasive, and has recently received considerable attention in clinical practice. Still, there is a lack of data and randomized controlled trials regarding acupotomy related to LSS. Additional studies are necessary, considering the low methodological quality and small size of the study., Methods and Analysis: This is a pragmatic, pilot, randomized controlled trial. The trial comprises 8 weeks of treatment, with 16 visits and a 4-week follow-up period. Forty participants diagnosed with LSS will be randomly assigned to either the experimental or control groups; both groups will receive acupuncture and interferential current therapy twice a week for 8 weeks, while the experimental group will receive an additional acupotomy intervention once a week for 8 weeks. The primary outcome will be assessed using the visual analog scale; the secondary outcome will be measured by self-rated walking distance, Oswestry Disability Index, and short-form McGill Pain Questionnaire. Measurements will be obtained prior to the start of the clinical trial, 4 weeks after the interventional procedure, 8 weeks after the procedure, and 4 weeks after the end of the interventional procedure. Blood tests and adverse reactions will be performed to ensure safety of the treatments., Conclusion: We expect that this study will provide basic data for future large-scale acupotomy studies regarding LSS., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2021
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7. Safety and feasibility of symptom-limited cardiopulmonary exercise test using the modified Naughton protocol in children with cerebral palsy: An observational study.
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Kim AR, Suk MH, and Kwon JY
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- Cerebral Palsy epidemiology, Chi-Square Distribution, Child, Electrocardiography methods, Exercise Test methods, Exercise Test statistics & numerical data, Feasibility Studies, Female, Humans, Male, Patient Safety, Republic of Korea epidemiology, Cerebral Palsy classification, Exercise Test standards
- Abstract
Abstract: Variables derived from the cardiopulmonary exercise test (CPX) provide objective information regarding the exercise capacity of children with cerebral palsy (CP), which can be used as the basis for exercise recommendations. Performing maximal CPX might not be appropriate, safe, or practical for children with CP. In the present study, the safety and feasibility of symptom-limited CPX using the modified Naughton protocol, a submaximal protocol, were investigated in children with CP, Gross Motor Function Classification System (GMFCS) level I or II. The present study included 40 children aged 6 to 12 years with CP who underwent symptom-limited CPX. CPX was performed to measure cardiopulmonary fitness using a treadmill with a modified Naughton protocol. Motor capacity was assessed using the Gross Motor Function Measure (GMFM), Pediatric Balance Scale (PBS), Timed Up and Go (TUG) test, and 6-minute walk test. Thirty-seven children with CP successfully completed testing without any adverse events during or immediately after CPX (dropout rate 7.5%). The reason for test termination was dyspnea (51.4%) or leg fatigue (48.6%). Based on the respiratory exchange ratio (RER), 21 of 37 (56.8%) children chose premature termination. The relationship between the reason for test termination and RER was not statistically significant (Spearman rho = 0.082, P = .631). CPX exercise time was strongly correlated with GMFM (Spearman rho = 0.714) and moderate correlation with PBS (Spearman rho = 0.690) and TUG (Spearman rho = 0.537). Peak oxygen uptake during CPX showed a weak correlation with GMFM and a moderate correlation with PBS. This study revealed that symptom-limited CPX using the modified Naughton protocol was safe and feasible for children with CP and GMFCS level I or II., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2021
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8. Does polydeoxyribonucleotide has an effect on patients with tendon or ligament pain?: A PRISMA-compliant meta-analysis.
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Gwak DW, Hwang JM, Kim AR, and Park D
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- Humans, Injections, Musculoskeletal Pain diagnosis, Pain Measurement, Tendinopathy diagnosis, Treatment Outcome, Analgesics therapeutic use, Ligaments, Musculoskeletal Pain drug therapy, Polydeoxyribonucleotides therapeutic use, Tendinopathy drug therapy
- Abstract
Background: Pain in the tendons or ligaments is extremely common, accounting for 30% of the causes of visiting general practitioners. Polydeoxyribonucleotide (PDRN) is emerging as a new treatment for musculoskeletal pain. However, the effects of PDRN in patients with tendon or ligament pain are unclear. Therefore, this study aimed to determine the impact of PDRN in patients with tendon or ligament pain through a meta-analysis., Methods: Electronic literature search of PubMed, Embase, SCOPUS, and Cochrane Library databases of all articles on PDRN treatment for patients with tendon or ligament pain published in the English language from inception until January 31, 2020. The search identified 262 citations., Results: One randomized controlled trial and 3 retrospective observational studies were included. Pain due to tendon or ligament disorders showed significant improvement after PDRN injection (standardized mean difference [SMD] = -1.43, 95% confidence interval [CI] = -1.80 to -1.06, P < .00001). In the subanalysis of patients with rotator cuff tendinopathy, rotator cuff tendinopathy-induced pain significantly improved (SMD = -2.34, 95% CI = -3.61 to -1.07, P = .0003) after PDRN injection. However, there was no difference in shoulder pain and disability index score and strength of shoulder abduction in patients with rotator cuff tendinopathy (shoulder pain and disability index score, SMD = 1.16, 95% CI = -1.20 to 3.52, P = .34; strength of shoulder abduction, SMD = 0.42, 95% CI = -0.03 to 0.88, P = .07)., Conclusion: Effective pain relief was achieved in patients with tendon or ligament disorders after PDRN injection. To more precisely determine this effect, a meta-analysis with a larger number of clinical trials is warranted., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2021
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9. Alterations of functional connectivity in auditory and sensorimotor neural networks: A case report in a patient with cortical deafness after bilateral putaminal hemorrhagic stroke.
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Gwak DW, Park E, Park JS, Kim E, Kang MG, Kim AR, Lee JE, Jung SH, Jeong JG, Lee KY, Chang Y, and Jung TD
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- Adult, Auditory Cortex physiopathology, Female, Hearing Loss, Central physiopathology, Hemorrhagic Stroke complications, Hemorrhagic Stroke physiopathology, Humans, Mental Status and Dementia Tests, Nerve Net physiopathology, Putaminal Hemorrhage complications, Putaminal Hemorrhage physiopathology, Sensorimotor Cortex physiopathology, Auditory Cortex abnormalities, Hearing Loss, Central etiology, Nerve Net abnormalities, Sensorimotor Cortex abnormalities
- Abstract
Rationale: Cortical deafness is a rare auditory dysfunction caused by damage to brain auditory networks. The aim was to report alterations of functional connectivity in intrinsic auditory, motor, and sensory networks in a cortical deafness patient., Patient Concerns: A 41-year-old woman suffered a right putaminal hemorrhage. Eight years earlier, she had suffered a left putaminal hemorrhage and had minimal sequelae. She had quadriparesis, imbalance, hypoesthesia, and complete hearing loss., Diagnoses: She was diagnosed with cortical deafness. After 6 months, resting-state functional magnetic resonance imaging (rs-fMRI) and diffuse tensor imaging (DTI) were performed. DTI revealed that the acoustic radiation was disrupted while the corticospinal tract and somatosensory track were intact using deterministic tracking methods. Furthermore, the patient showed decreased functional connectivity between auditory and sensorimotor networks., Interventions: The patient underwent in-patient stroke rehabilitation therapy for 2 months., Outcomes: Gait function and ability for activities of daily living were improved. However, complete hearing impairment persisted in 6 months after bilateral putaminal hemorrhagic stroke., Lessons: Our case report seems to suggest that functional alterations of spontaneous neuronal activity in auditory and sensorimotor networks are related to motor and sensory impairments in a patient with cortical deafness., Competing Interests: The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2021
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10. Effectiveness and safety of polydioxanone thread-embedding acupuncture (TEA) and electroacupuncture (EA) treatment for knee osteoarthritis (KOA) patients with postoperative pain: An assessor-blinded, randomized, controlled pilot trial.
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Lee YJ, Han CH, Jeon JH, Kim E, Kim JY, Park KH, Kim AR, Lee EJ, and Kim YI
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- Arthroscopy, Bone Transplantation, Cartilage transplantation, Chondrocytes transplantation, Combined Modality Therapy, Electroacupuncture, Humans, Musculoskeletal Pain etiology, Osteoarthritis, Knee complications, Osteoarthritis, Knee surgery, Pain Measurement, Pilot Projects, Postoperative Period, Randomized Controlled Trials as Topic, Severity of Illness Index, Single-Blind Method, Acupuncture Therapy methods, Musculoskeletal Pain therapy, Osteoarthritis, Knee therapy, Polydioxanone administration & dosage
- Abstract
Background: Degenerative knee osteoarthritis (KOA) shows an increase in morbidity with improvement in the living conditions and extended lifespans. Treatment for degenerative KOA has been gaining attention since it significantly affects the life of the elderly population and is also associated with increased expenses for medical services and high socioeconomic costs. Treatments for degenerative KOA include nondrug therapy, drug therapy, and surgical treatment. For cases that show little response to conservative treatment but have not involved severe deformation of the knee, procedures such as arthroscopic surgery, autologous chondrocyte implantation, or autologous osteochondral transplantation can be performed. However, effective treatment is required for patients experiencing sustained knee pain after surgery. Although studies confirming the therapeutic effects of acupuncture or thread-embedding acupuncture (TEA) treatment for degenerative KOA have been reported, clinical studies on a combination of TEA and electroacupuncture (EA) in patients complaining of knee pain after arthroscopic surgery, autologous chondrocyte implantation, or autologous osteochondral transplantation have not yet been reported. Therefore, this study aimed to evaluate the effectiveness and safety of this combination treatment in patients with persistent knee pain after arthroscopic surgery, autologous chondrocyte implantation, or autologous osteochondral transplantation., Methods/design: This study has been designed as a 2-group, parallel, single-center, randomized, controlled, assessor-blinded trial. Thirty-six patients with degenerative KOA who complained of pain even after arthroscopic surgery, autologous chondrocyte implantation, or autologous osteochondral transplantation will be randomized to either the (TEA + EA + Usual care) group or the (Usual care only) group in a 1:1 ratio. The patients in the (TEA + EA + Usual care) group will receive TEA treatment once a week for 4 weeks for a total of 4 sessions and EA twice a week for a total of 8 sessions while continuing usual care. The (Usual care only) group will only receive usual care for 4 weeks. To assess the efficacy of the TEA and EA combination treatment, the visual analogue scale, the Korean version of the Western Ontario and McMaster Universities Osteoarthritis Index, the EuroQol 5-Dimension 5-Level, and the doses of the rescue drug taken will be evaluated at baseline (1W) and weeks 2 (2W), 4 (4W), 6 (6W), and 8 (8W). The primary efficacy endpoint is the mean change in visual analogue scale at week 4 (4W) compared to baseline. Adverse events will be assessed at every visit., Discussion: This study will provide useful data for evaluating the clinical efficacy and safety of TEA and electroacupuncture combination treatment for improving pain and quality of life after surgery for degenerative KOA., Trial Registration: Clinical Research Information Service of Republic of Korea (CRIS- KCT0004804), March 6, 2020.
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- 2020
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11. Dramatic effect in passive ROM exercise under sedation in a patient with intractable complex regional pain syndrome (type I): A case report.
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Oh HM, Kim CH, and Kim AR
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- Female, Humans, Hypnotics and Sedatives administration & dosage, Range of Motion, Articular, Young Adult, Complex Regional Pain Syndromes rehabilitation, Hypnotics and Sedatives therapeutic use, Physical Therapy Modalities
- Abstract
Rationale: Complex regional pain syndrome (CRPS) usually occurs after trauma and surgery but can also occur spontaneously. There are various known pathophysiology and treatment protocols for CRPS. However, there is no established treatment guideline. Although physical therapy is known as the first line treatment for CRPS, performing physical therapy is difficult due to severe pain. This case reports the first case with positive effect of physical therapy under sedation that allowed early physical therapy., Patient Concerns: A 19-year old female had her right elbow area slightly hit by someone else, after which it began to swell and become more painful. Active and passive range of motion (ROM) of the right upper extremity gradually decreased through 3 months, and pain and edema worsened., Diagnoses: She had allodynia, nonpitting edema, temperature asymmetry, and trophic change in fingernails in the right upper extremity, which met the diagnostic criteria for CRPS. In the 3-phase bone scan, which is a specific tool to diagnose CRPS, there was trace uptake increase in the right elbow and wrist, indicating possibility of CRPS., Interventions: Despite conventional treatments such as pharmacologic and interventional therapies, neither pain nor edema subsided. Pain was so severe that it was impossible to apply physical therapy. Therefore, the patient underwent passive ROM exercise in the right upper extremity under sedation for 30 minutes, which was relatively easier due to decreased pain. After 2 days of passive ROM exercise under sedation, the patient was able to receive passive ROM exercise twice daily without sedation for 18 days., Outcomes: After 20 days of passive ROM exercise, including 2 days of passive ROM exercise under sedation, the circumference of her right hand decreased by 5 cm, wrist 2 cm, and elbow 6 cm compared to the initial measurement. Numeric pain rating scale improved from 9 to 3, and her manual muscle test marked fair plus from trace, Jebsen-Taylor hand function test score 43 from 0., Lessons: This case suggests that passive ROM exercise under sedation may be a successful alternative as a treatment when exercise, currently known as a treatment to CRPS, is impossible.
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- 2019
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12. Can the integrity of the corticospinal tract predict the long-term motor outcome in poststroke hemiplegic patients?
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Kim AR, Kim DH, Park SY, Kyeong S, Kim YW, Lee SK, and Kim DY
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- Adult, Aged, Aged, 80 and over, Cognition Disorders etiology, Diffusion Tensor Imaging, Female, Humans, Image Processing, Computer-Assisted, Male, Middle Aged, Psychomotor Performance physiology, Walking, Young Adult, Cerebral Cortex diagnostic imaging, Hemiplegia diagnostic imaging, Hemiplegia etiology, Motor Activity physiology, Pyramidal Tracts diagnostic imaging, Stroke complications
- Abstract
This study aimed to investigate the long-term motor outcome according to early diffusion tensor tractography findings for the affected corticospinal tract (CST) in poststroke hemiplegic patients. A total of 48 supratentorial subacute patients after stroke were enrolled, who had a brain MRI scan within 6 weeks from onset, and no stroke recurrence reported within the 2-year follow-up period. Diffusion tensor images were obtained and CSTs were reconstructed. The participants were classified into three groups: type A, the CST originating from the primary motor cortex was preserved around the lesion area; type B, the CST was similar to type A, except that the fiber originated from the area adjacent to the primary motor cortex; and type C, the CST was interrupted or not shown. Motor functions using Fugl-Meyer Motor Assessment (FMA), the Box and Block Test (BBT), and Functional Ambulation Category, and cognitive function using Mini-Mental Status Examination (MMSE) were measured at baseline and at 2 years from stroke onset. Changes in FMA and BBT were significantly different according to diffusion tensor tractography type at follow-up (P<0.05), but Functional Ambulation Category and Mini-Mental Status Examination were not. In post-hoc analysis, groups A and B showed greater significant improvements on the BBT and on the upper FMA subscale (shoulder/elbow, wrist, and hand) compared with group C (corrected P<0.05), but did not on lower FMA. This study showed the importance of CST integrity for stoke motor recovery. The early integrity of the CST may be useful in predicting long-term motor outcomes, specifically with motor recovery of the upper extremity and hand function.
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- 2018
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13. The neutrophil-to-lymphocyte ratio could be a good diagnostic marker and predictor of relapse in patients with adult-onset Still's disease: A STROBE-compliant retrospective observational analysis.
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Seo JY, Suh CH, Jung JY, Kim AR, Yang JW, and Kim HA
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- Adult, Age Factors, Area Under Curve, Blood Sedimentation, Diagnosis, Differential, Female, Follow-Up Studies, Humans, Leukocyte Count, Logistic Models, Lupus Erythematosus, Systemic blood, Macrophage Activation Syndrome blood, Male, Multivariate Analysis, Prognosis, ROC Curve, Recurrence, Retrospective Studies, Still's Disease, Adult-Onset drug therapy, Still's Disease, Adult-Onset immunology, Still's Disease, Adult-Onset mortality, Lymphocytes, Neutrophils, Still's Disease, Adult-Onset blood
- Abstract
The neutrophil-to-lymphocyte ratio (NLR) is the proportion of absolute neutrophil count to lymphocytes on routine complete blood count (CBC) tests, and has been studied as a simple marker of the systemic inflammatory response. This study was performed to investigate whether the NLR could be used as a tool to diagnose and predict prognosis in cases of adult-onset Still's disease (AOSD).We retrospectively reviewed 164 patients with suspected AOSD. Among 164 patients with suspected AOSD, 37 patients received another diagnosis (such as viral infection) and were compared with the 127 patients who received a diagnosis of AOSD. Laboratory tests including CBCs, ferritin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, and the NLR were evaluated.AOSD patients showed higher neutrophil counts, lower lymphocyte counts, higher NLRs, and higher levels of ferritin, ESR, and CRP than non-AOSD patients (all P < .001). In receiver operating characteristic (ROC) curve analysis of the NLR for diagnosis of AOSD, the area under the curve (AUC) was highest at 0.967 (95% CI = 0.940-0.993) with a cutoff value of 3.08. The cutoff value showed the greatest sensitivity (91.7%), specificity (68.4%), and AUC value (0.967) as a diagnostic tool for AOSD. The NLR and treatment appeared to be significant prognostic factors for relapse, but only age showed a significant relationship with death. Furthermore, the NLR was significantly higher in patients with macrophage activation syndrome than in hemophagocytic lymphohistiocytosis (HLH) patients (P = .007). In ROC analysis, the NLR with a cutoff value of 5.86 showed a sensitivity of 89.4%, specificity of 87.8%, and AUC of 0.794.The NLR can be used as a diagnostic tool and predictor of relapse in AOSD, and for differential diagnosis of HLH.
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- 2017
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14. A Randomized Controlled Trial of Vagus Nerve-preserving Distal Gastrectomy Versus Conventional Distal Gastrectomy for Postoperative Quality of Life in Early Stage Gastric Cancer Patients.
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Kim SM, Cho J, Kang D, Oh SJ, Kim AR, Sohn TS, Noh JH, and Kim S
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- Demography, Diarrhea epidemiology, Female, Humans, Male, Middle Aged, Neoplasm Staging, Postoperative Complications epidemiology, Republic of Korea epidemiology, Stomach Neoplasms pathology, Treatment Outcome, Gastrectomy methods, Quality of Life, Stomach Neoplasms surgery, Vagus Nerve surgery
- Abstract
Objective: To compare the postoperative quality of life of vagus nerve preserving distal gastrectomy (VPG) vs conventional distal gastrectomy (CG) in patients with early-stage gastric cancer., Design: Randomized controlled clinical trial., Setting: Large tertiary comprehensive cancer center in Korea., Participants: One hundred sixty-three patients with early gastric cancer 18 years of age or older expected to undergo curative gastric resection., Intervention: Patients were randomized 1:1 to VPG (n = 85) or CG (n = 78)., Main Outcome Measures: European Organization for Research and Treatment of Cancer (EORTC) gastric module (STO22)., Results: Patients assigned to VPG showed less diarrhea 3 and 12 months after surgery (P = 0.040 and 0.048, respectively) and less appetite loss at 12 months (P = 0.011) compared with those assigned to CG. In both groups, fatigue, anxiety, eating restriction, and body image deteriorated at 3 months after surgery and did not regain baseline levels 12 months after surgery. There were no significant differences between the 2 groups in cancer recurrence and death over 5 years of follow-up., Conclusions: Early gastric cancer patients undergoing VPG reported significantly less diarrhea and appetite loss at 12 months postsurgery compared with those undergoing CG, with no differences in long-term clinical outcomes. VPG may improve the quality of life after gastrectomy in early gastric cancer patients compared with CG.
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- 2016
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15. Unraveling of Enigmatic Hearing-Impaired GJB2 Single Heterozygotes by Massive Parallel Sequencing: DFNB1 or Not?
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Kim SY, Kim AR, Kim NKD, Lee C, Kim MY, Jeon EH, Park WY, and Choi BY
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- Adolescent, Adult, Child, Child, Preschool, Connexin 26, Female, Humans, Infant, Male, Pedigree, Connexins genetics, Hearing Loss, Sensorineural genetics, Heterozygote, High-Throughput Nucleotide Sequencing, Mutation
- Abstract
The molecular etiology of nonsyndromic sensorineural hearing loss (SNHL) in subjects with only one detectable autosomal recessive GJB2 mutation is unclear. Here, we report GJB2 single heterozygotes with various final genetic diagnoses and suggest appropriate diagnostic strategies. A total of 160 subjects with SNHL without phenotypic markers were screened for GJB2 mutations. Single-nucleotide variants or structural variations within the DFNB1 locus or in other deafness genes were examined by Sanger sequencing, breakpoint PCR, and targeted exome sequencing (TES) of 129 deafness genes. We identified 27 subjects with two mutations and 10 subjects with only one detectable mutation in GJB2. The detection rate of the single GJB2 mutation among the 160 SNHL subjects in the present study (6.25%) was higher than 2.58% in normal hearing controls in Korean. The DFNB1 was clearly excluded as a molecular etiology in four (40%) subjects: other recessive deafness genes (N = 3) accounted for SNHL and the causative gene for the other non-DFNB1 subject (N = 1) was not identified. The etiology of additional two subjects was potentially explained by digenic etiology (N = 2) of GJB2 with MITF and GJB3, respectively. The contribution of the single GJB2 mutation in the four remaining subjects is unclear. Comprehensive diagnostic testing including TES is prerequisite for understanding GJB2 single heterozygotes., Competing Interests: The authors have no conflicts of interest to disclose.
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- 2016
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16. Refinement of Molecular Diagnostic Protocol of Auditory Neuropathy Spectrum Disorder: Disclosure of Significant Level of Etiologic Homogeneity in Koreans and Its Clinical Implications.
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Chang MY, Kim AR, Kim NKD, Lee C, Park WY, and Choi BY
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- Asian People, Audiometry, Cochlear Nerve, Disclosure, Female, Hearing Loss, Central diagnosis, Humans, Male, Mutation, Pathology, Molecular, Phenotype, Hearing Loss, Central genetics, Membrane Proteins genetics
- Abstract
Auditory neuropathy spectrum disorder (ANSD) is a sensorineural hearing disorder caused by dysfunction of auditory neural conduction. ANSD has a heterogeneous etiology, including genetic factors; the response to cochlear implantation significantly varies depending on the etiology. The results of timely cochlear implantation for OTOF-related ANSD (DFNB9) have been reported to be good. Therefore, identifying the causative gene of ANSD, especially OTOF, is an important issue to rehabilitate these patients.Six sporadic ANSD subjects without anatomical abnormality of the cochlear nerve, including the 4 subjects that were previously reported to be without detectable OTOF mutation, were included. We performed targeted resequencing (TRS) of known deafness genes and multiphasic bioinformatics analyses of the data that ensured detection of capture failure and structural variations. Exclusion of SNP was also double checked. The TRS data previously obtained from 2 subjects were reanalyzed. Through this study, we detected 2 mutant alleles of OTOF from 5 (83.3%) of 6 ANSD subjects. All of the 5 subjects carried at least 1 mutant allele carrying p.R1939Q. This variant was categorized as a simple SNP (rs201326023) in the database and it resided in the exon with frequent capture failures, which previously led to exclusion of this variant from eligible candidacy mistakenly. In addition, we detected a structural variation within OTOF from a previously undiagnosed ANSD subject, which was the second structural variation reported in DFNB9 subjects to date.We identify a strong etiologic homogeneity of prelingual ANSD in case of the anatomically normal cochlear nerve in Koreans and now report DFNB9 as the single overwhelming cause. Multiphasic analysis of TRS data ensuring detection of capture failure and structural variations would be expected to reveal DFNB9 from a substantial portion of previously undiagnosed ANSD subjects in Koreans. Based on our results, we propose a novel strategy that incorporates imaging studies, prevalent mutation screening and multiphasic analysis of TRS data in a stepwise manner to correctly detect DFNB9 in Koreans., Competing Interests: The authors have no conflicts of interest to disclose.
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- 2015
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17. Molecular Etiology of Hereditary Single-Side Deafness: Its Association With Pigmentary Disorders and Waardenburg Syndrome.
- Author
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Kim SH, Kim AR, Choi HS, Kim MY, Chun EH, Oh SH, and Choi BY
- Subjects
- DNA Mutational Analysis, PAX3 Transcription Factor, Hearing Loss, Unilateral genetics, Microphthalmia-Associated Transcription Factor genetics, Paired Box Transcription Factors genetics, Pigmentation genetics, Waardenburg Syndrome diagnosis
- Abstract
Unilateral sensorineural hearing loss (USNHL)/single-side deafness (SSD) is a frequently encountered disability in children. The etiology of a substantial portion of USNHL/SSD still remains unknown, and genetic causes have not been clearly elucidated. In this study, the authors evaluated the heritability of USNHL/SSD.The authors sequentially recruited 50 unrelated children with SSD. For an etiologic diagnosis, we performed a rigorous review on the phenotypes of family members of all children and conducted, if necessary, molecular genetic tests including targeted exome sequencing of 129 deafness genes.Among the 50 SSD children cohort, the authors identify 4 (8%) unrelated SSD probands from 4 families (SH136, SB173, SB177, and SB199) with another hearing impaired family members. Notably, all 4 probands in our cohort with a familial history of SSD also have pigmentary abnormalities such as brown freckles or premature gray hair within first degree relatives, which may indicate that genes whose products are involved with pigmentary disorder could be candidates for heritable SSD. Indeed, SH136 and SB199 turned out to segregate a mutation in MITF and PAX3, respectively, leading to a molecular diagnosis of Waardenburg syndrome (WS).We report, for the first time in the literature, a significant heritability of pediatric SSD. There is a strong association between the heritability of USNHL/SSD and the pigmentary abnormality, shedding a new light on the understanding of the molecular basis of heritable USNHL/SSD. In case of children with congenital SSD, it would be mandatory to rigorously screen pigmentary abnormalities. WS should also be included in the differential diagnosis of children with USNHL/SSD, especially in a familial form.
- Published
- 2015
- Full Text
- View/download PDF
18. Targeted Exome Sequencing of Deafness Genes After Failure of Auditory Phenotype-Driven Candidate Gene Screening.
- Author
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Kim BJ, Kim AR, Park G, Park WY, Chang SO, Oh SH, and Choi BY
- Subjects
- Cohort Studies, Connexin 26, Connexins genetics, Deafness physiopathology, Extracellular Matrix Proteins genetics, Genes, Dominant, Genetic Variation, Hearing Loss, Sensorineural genetics, Hearing Loss, Sensorineural physiopathology, Humans, PAX3 Transcription Factor, Paired Box Transcription Factors genetics, Pedigree, Phenotype, Prospective Studies, Deafness genetics, Exome genetics, Genetic Testing methods, Hearing genetics
- Abstract
Objective: To demonstrate the efficacy and advantages of targeted exome sequencing (TES) of known deafness genes in cases with failed or misleading auditory phenotype-driven candidate gene screening., Study Design: Prospective cohort survey., Setting: Otolaryngology department of a tertiary referral hospital., Patients: Six hearing-impaired probands with seemingly non-syndromic features from six deaf families were enrolled in this study after failure of genetic diagnosis using auditory phenotype-driven candidate gene screening., Intervention: TES of known deafness genes was performed in the six probands, and a final causative variant was pursued using subsequent filtering steps., Main Outcome Measure: Potential causative variants determined using TES were confirmed by previously introduced filtering steps., Results: We detected causative variants in three (50%) of six families, and these variants were in the COCH, PAX3, and GJB2 genes. Additionally, we also recapitulated the recent finding from other report arguing for the non-pathogenic potential of MYO1A variant., Conclusions: TES of a deafness panel provides a comprehensive genetic screening tool that can be implemented without being misled by the audiogram configuration information and can complement incomplete clinical physical examinations. In addition, the secondary incidental finding obtained by TES contributes useful information regarding the deafness field.
- Published
- 2015
- Full Text
- View/download PDF
19. Changes of quality of life in gastric cancer patients after curative resection: a longitudinal cohort study in Korea.
- Author
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Kim AR, Cho J, Hsu YJ, Choi MG, Noh JH, Sohn TS, Bae JM, Yun YH, and Kim S
- Subjects
- Adult, Aged, Cohort Studies, Female, Humans, Longitudinal Studies, Male, Middle Aged, Prospective Studies, Remission Induction, Republic of Korea, Young Adult, Gastrectomy, Quality of Life, Stomach Neoplasms surgery
- Abstract
Objective: Little is known about how quality of life (QOL) changes over time after gastrectomy. We prospectively examined changes of QOL in Korean patients with gastric cancer after curative resection., Background: As early detection and improved treatment have led to higher survival rates and an increasing number of long-term survivors, the importance of QOL has increased., Methods: Patients newly diagnosed with gastric cancer, who were expected to undergo curative resection, were studied. QOL was assessed, using the European Organization for Research and Treatment of Cancer QLQ-C30 and its gastric module QLQ-STO22, before and after 3 and 12 months of gastrectomy., Results: In total, 465 patients were included in the study, and 377 and 88 patients underwent subtotal gastrectomy and total gastrectomy, respectively. For most of the functional or symptom scales, the mean score deteriorated at 3 months and generally improved during follow-up period. Patients with total gastrectomy had more functional and symptomatic problems related to QOL than those with subtotal gastrectomy during the follow-up. For both groups, there were temporal, unrecovered, improved, and unchanged problems in QOL. Fatigue; digestive symptoms such as diarrhea, dysphagia, and eating restrictions; body image disturbance; and cognitive functioning were the representative unrecovered problems, which persisted at 12 months after surgery., Conclusions: Our findings show that there are various functional and symptomatic problems, which health care providers need to manage during the postsurgical period. We need to continuously address fatigue, diarrhea, dysphagia, eating restrictions, body image disturbance, and cognitive functioning. In addition, it would be necessary to inform patients about possible QOL outcomes while they are receiving information about surgery and signing informed consent for surgery.
- Published
- 2012
- Full Text
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20. A prospective evaluation of psoas muscle and intravascular injection in lumbar sympathetic ganglion block.
- Author
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Hong JH, Kim AR, Lee MY, Kim YC, and Oh MJ
- Subjects
- Adult, Aged, Aged, 80 and over, Contrast Media administration & dosage, Contrast Media adverse effects, Female, Fluoroscopy, Humans, Injections, Male, Medical Errors, Middle Aged, Predictive Value of Tests, Prospective Studies, Psoas Muscles diagnostic imaging, Skin Temperature drug effects, Spine diagnostic imaging, Autonomic Nerve Block adverse effects, Ganglia, Sympathetic, Lumbosacral Region, Psoas Muscles drug effects
- Abstract
Background: Intravascular and intramuscular injection of local anesthetics during lumbar sympathetic ganglion block (LSGB) can cause false positive or negative results in a diagnostic block, and complications. In the present study, we prospectively evaluated the incidence and possible factors causing intravascular and IM injection during LSGB., Methods: We evaluated 216 LSGBs in 83 patients. All LSGBs were performed by 1 of the authors using a 3-needle technique. After final needle position was confirmed by biplanar fluoroscopy, an aspiration test was conducted, and 1 mL of contrast was injected sequentially. Incidences of psoas muscle injection, blood flashback, and the presence of intravascular contrast spread on static and real-time fluoroscopy were assessed., Results: The incidence of psoas muscle injection of contrast was 21.3% (46/216), and it was associated with the level of injection (L2) significantly (chi(2) = 14.773, P = 0.001). The incidence of intravascular injection of contrast was 12.5% (27/216). Among 27 cases of documented intravascular injections, 5.1% (11/216) of patients showed contrast spread at the area where the sympathetic ganglion was presumed to be and to the vessels simultaneously, and 7.4% (16/216) of patients showed only intravascular injection of contrast. The sensitivity of the aspiration test and static radiography were 40.7% and 70.4%, respectively., Conclusions: LSGB at the L2 level showed the lowest incidence of psoas muscle injection of contrast in comparison with LSGB at L3 and L4. The aspiration test and static radiography frequently missed the intravascular injection of contrast during LSGBs.
- Published
- 2010
- Full Text
- View/download PDF
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