Photobiomodulation therapy for the prevention of radiodermatitis in breast cancer patients

( Donghwi Jang ),( Hyun Jeong Byun ),( Jongeun Lee ),( Chan Seong Park ),( Youngkyoung Lim ),( Ji-hye Park ),( Jong-hee Lee ),( Dong-youn Lee ),( Joo-heung Lee ),( Jun-mo Yang ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Radiotherapy for breast cancer (BC) may accompany acute radiodermatitis and photobiomodulation therapy (PBMT) has been recently applied as a treatment option in diverse fields by promoting tissue repair. Objectives: To evaluate the effectiveness and safety of PBMT for the prevention of acute radiodermatitis in BC patients undergoing radiotherapy. Methods: The control group was 10 BC patients without PBMT and a total of 22 subjects was divided into two groups; group 1 and group 2 (11 subjects each, PBMT of wavelength 633 nm and 830nm, respectively). The degrees of radiodermatitis were assessed based on CTCAE grade and compared between the groups. The differences of skin measurements (melanin, erythema, moisture, and sebum content index) between the irradiated side and the non-irradiated side were evaluated at four time points and the changes were evaluated and compared between the groups. Results: The incidence of high grade radiodermatitis (more than grade 2a) was significantly higher in the control than in the PBMT groups right after the radiotherapy (p=0.0259). The differences in skin measurements at each time point were not significant between the groups except for moisture index which PBMT groups showed lesser change from the baseline compared to the control group right after the radiotherapy(ps <0.05). Conclusion: PBMT might play a role in the prevention of acute radiodermatitis in BC patients, which needs further study.

Underweight: another risk factor for cardiovascular disease? : A cross-sectional 2013 Behavioral Risk Factor Surveillance System (BRFSS) study of 491,773 individuals in the USA

Park, Donghwi,Lee, Jong-Hak,Han, Seungwoo Wolters Kluwer Health 2017 Medicine Vol.96 No.48

<▼1><P>Supplemental Digital Content is available in the text</P></▼1><▼2><P><B>Abstract</B></P><P>Obesity is a well-established risk factor for cardiovascular disease (CVD), but the underweight population of body mass index (BMI) below 18.5 kg/m<SUP>2</SUP> has not been an object of concern. The objective of this study is to investigate whether underweight could be an independent risk factor for CVD in a population-based cross-sectional study.</P><P>Cross-sectional data of 2013 Behavioral Risk Factor Surveillance System (BRFSS) database encompassing 491,773 US adult subjects were used to assess risk for CVD. Primary outcomes were the incidence and relative risks (RRs) of CVD including stroke, heart attack/myocardial infarction, or coronary artery disease according to BMI category. All analyses used weighted sampling probabilities of data source.</P><P>The underweight population had a 19.7% greater risk of CVD than did the normal-weight, and the overweight and obese population had a 50% and 96% increased risk, respectively. When adjusted with covariates, the relative risk for CVD elevated in underweight population (adjusted RR 1.34 [95% confidence interval (CI) 1.335–1.348]). Conversely, the adjusted relative risk was significantly attenuated in the obese group (adjusted RR 1.149 [95% CI 1.147–1.151]) and it was even insignificant in the overweight group (adjusted RR 1.00 [95% CI 1.000–1.003]). In subanalysis for each CVD category, being underweight among BMI status was the strongest independent risk factor for stroke (adjusted RR 1.441 [95% CI 1.431–1.450]), heart attack/ myocardial infarction (MI) (adjusted RR 1.23 [95% CI 1.217–1.233]), and angina/coronary artery disease (adjusted RR 1.20 [95% CI 1.189–1.206]). Especially among the population below 40-year old, relative risk estimates remained increased in the underweight population; persons who were underweight had a 2.3-fold greater adjusted relative risk of CVD as compared with those with normal weight when we stratified with age.</P><P>Underweight below BMI 18.5 kg/m<SUP>2</SUP> may be another risk factor for CVD, and CVD risk of the overweight and obese population largely depended on other comorbidities accompanied by obesity.</P></▼2>

Conference Summary of the 2022 Fall Conference of the Korean Pain Research Society

Donghwi Park,Sang-heon Lee,Hue Jung Park,Nackhwan Kim,Jin-Young Oh,Min Cheol Chang 대한통증연구학회 2022 International Journal of Pain Vol.13 No.2

On October 30, 2022, the 2022 Fall conference of the Korean Pain Research Society (KPRS), the Korean branch of the International Association of the Study of Pain (IASP), is a pivotal academic society that promotes research, exchange, and collaboration in all foundational disciplines and clinical fields related to pain (e.g., anesthesiology, neurosurgery, neurology, orthopedic surgery, rehabilitation medicine, mental health, and dentistry) and aims to attain the goals of the IASP, namely pain treatment and a multidisciplinary research approach. In this review, we summarized the programs of the 2022 Fall conference of the KPRS.

The Pathophysiology and Mechanism of Acute and Chronic Whiplash Injury: A Narrative Review

Donghwi Park 대한통증연구학회 2022 International Journal of Pain Vol.13 No.1

Patients with whiplash injuries usually complain of neck, shoulder, or back pain; dizziness; headache; vertigo; paresthesias; and cognitive or psychological symptoms. However, to date, whiplash injury also remains one of the most poorly understood motor vehicle injuries. The source of initial symptoms among patients with whiplash injuries is often unclear. It is generally assumed that the symptoms of patients with whiplash injuries have an organic basis. This review briefly summarized the pathophysiology and mechanisms being investigated by many researchers to potentially explain whiplash injury. Each anatomical area described is injured during a whiplash exposure if the impact during whiplash injuries exceeds that tissue’s tolerance. For each anatomical area affected during whiplash injuries, continued research is necessary to better understand the pathophysiology and mechanisms of whiplash injuries. A better understanding of each potentially injured anatomical area during whiplash injuries will help improve the management of whiplash injuries.

Lower limb muscle magnetic resonance imaging in myotonic dystrophy type 1 correlates with the six-minute walk test and CTG repeats

Park, Donghwi,Lee, Sang-Hoon,Shin, Jin-Hong,Park, Jin-Sung Elsevier 2018 Neuromuscular disorders Vol.28 No.1

<P><B>Abstract</B></P> <P>The aim of this study was to elucidate correlations among clinical, genetic, and magnetic resonance imaging (MRI) data of muscles in myotonic dystrophy type 1 (DM1). We retrospectively reviewed the medical records and images of nineteen patients with DM1 from different families. We retrieved the genetic data (CTG repeats) and the clinical data, which included disease duration, creatine kinase level, sum score of manual muscle testing, modified Medical Research Council sum score, and the six-minute walk test results (6MWT). The correlation analyses showed a statistically significant correlation between the modified Medical Research Council sum score and CTG repeat numbers. Among the lower extremity muscles, 6MWT correlated most with the sum of the ankle plantar-flexors (the soleus, medial, and lateral gastrocnemius muscles). Compared to the other plantar-flexor muscles, the soleus muscle presented the highest correlation with the 6MWT. Additionally, our results showed that the CTG repeat numbers did not correlate with the 6MWT. However, it correlated with the modified Medical Research Council sum score. The ankle plantar-flexor muscles were the most severely affected muscles revealed in the whole body MRI, and presented statistically significant correlation with the 6MWT. Among the plantar-flexor muscles, the soleus muscle most influenced the 6MWT.</P> <P><B>Highlights</B></P> <P> <UL> <LI> The ankle plantar-flexor muscles were the most severely affected muscles in DM1 patients. </LI> <LI> The 6MWT correlated best with the semi-quantitative MRI score of the ankle plantar-flexors. </LI> <LI> Among the plantar-flexor muscles, the soleus muscle was the muscle that most influenced the 6MWT. </LI> </UL> </P>

The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review

Donghwi Park,장민철 영남대학교 의과대학 2022 Yeungnam University Journal of Medicine Vol.39 No.3

Pain from nervous or musculoskeletal disorders is one of the most common complaints in clinical practice. Corticosteroids have a high pain-reducing effect, and their injection is generally used to control various types of pain. However, they have various adverse effects including flushing, hyperglycemia, allergic reactions, menstrual changes, immunosuppression, and adrenal suppression. Pulsed radiofrequency (PRF) is known to have a pain-reducing effect similar to that of corticosteroid injection, with nearly no major side effects. Therefore, it has been widely used to treat various types of pain, such as neuropathic, joint, discogenic, and muscle pain. In the current review, we outlined the pain-reducing mechanisms of PRF by reviewing previous studies. When PRF was first introduced, it was supposed to reduce pain by long-term depression of pain signaling from the peripheral nerve to the central nervous system. In addition, deactivation of microglia at the level of the spinal dorsal horn, reduction of proinflammatory cytokines, increased endogenous opioid precursor messenger ribonucleic acid, enhancement of noradrenergic and serotonergic descending pain inhibitory pathways, suppression of excitation of C-afferent fibers, and microscopic damage of nociceptive C- and A-delta fibers have been found to contribute to pain reduction after PRF application. However, the pain-reducing mechanism of PRF has not been clearly and definitely elucidated. Further studies are warranted to clarify the pain-reducing mechanism of PRF.

Content Analysis of YouTube Videos on the Effect of Vitamin C on Common Cold

Park Donghwi,Kwak Sang Gyu,Kim Saeyoon,Chang Min Cheol 대한가정의학회 2023 Korean Journal of Family Medicine Vol.44 No.6

Background: With the growth of the Internet, social media platforms have emerged as major sources of medical in-formation. We assessed the reliability, quality, and accuracy of the most-viewed YouTube videos containing infor-mation on the effect of vitamin C on the common cold.Methods: The YouTube videos were searched on August 1, 2022, using the keywords: (“ascorbic acid” OR “vitamin C” OR “Sodium Ascorbate” OR “L-ascorbic”) AND “common cold”. The 30 most-viewed videos were included in our study. The reliability and quality of the videos were analyzed using modified DISCERN and Global Quality Scales, respectively. When the videos included at least one correct or inaccurate scientific statement about the ef-fect of vitamin C on the common cold, they were classified as accurate or misleading videos, respectively; those without any pertinent information were considered neither accurate nor misleading. If a video contained both ac-curate and inaccurate statements, it was classified as misleading.Results: Of the 30 most-viewed videos, 73% were unreliable, and 67% contained misleading information and were of a poor quality. Of these 30 videos, 14 videos were produced and posted by customers who were not specialized in medicine or nutrition. Moreover, these videos were of significantly lower reliability, quality, and accuracy than those produced by nutrition or fitness channels or by medical or nutrition professionals.Conclusion: The reliability, quality, and accuracy of videos uploaded by non-professionals were low. Therefore, video creators should upload reliable, high-quality videos to ensure the dissemination of accurate medical infor-mation.

Five-year serial follow-up of muscle MRI in adult onset myotonic dystrophy type 1 : A case report

Park, Jin-Sung,Park, Donghwi Wolters Kluwer Health 2018 Medicine Vol.97 No.4

<P><B>Abstract</B></P><P><B>Rationale:</B></P><P>Although several studies have described the involvement pattern of myotonic dystrophy type 1 (DM1) using muscle MRI, most of these studies have limitations as cross-sectional studies. To the best of our knowledge, there have been no reports of longitudinal studies describing muscle involvement patterns in patients with DM1 via serial MRI.</P><P><B>Patient concerns:</B></P><P>Progressive weakness of both lower extremities.</P><P><B>Diagnosis:</B></P><P>Two patients with DM1.</P><P><B>Intervention:</B></P><P>The serial muscle MRI performed in the 2 patients with DM1.</P><P><B>Outcomes:</B></P><P>The serial muscle MRI showed early involvement of proximal (tensor fascia latae) and truncal muscles (spine extensor muscles), and these longitudinal imaging may be helpful to reveal the pattern of muscle involvement in patients with DM1.</P><P><B>Lessons:</B></P><P>Since most previous studies on muscle involvement patterns in DM1 patients were cross-sectional studies, this case series of studying muscle involvement patterns through serial MRI in patients with DM1 may have significant clinical significance.</P>

Effect of Polydeoxyribonucleotide Injection in a Patient With Carpal Tunnel Syndrome

Park, Jin-Sung,Park, Donghwi Wolters Kluwer Health, Inc. All rights reserved. 2018 AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITA Vol.97 No.10

<P>Ultrasound-guided corticosteroid injection into the carpal tunnel is widely performed for the management of carpal tunnel syndrome. However, this injection may worsen the condition in patients with type 2 diabetes mellitus. Polydeoxyribonucleotide was recently recognized as a substitute for corticosteroid because of its anti-inflammatory effects. A 41-yr-old woman with type 2 diabetes mellitus was admitted to our rehabilitation clinic with a 1-mo history of numbness and tingling in her right hand and first three fingers tips. She declined corticosteroid treatment because of a previous episode of uncontrolled blood glucose levels after corticosteroid injection. Therefore, ultrasound-guided polydeoxyribonucleotide injections into the carpal tunnel were carried out. At the 6-mo follow-up, the patient demonstrated an improvement in the carpal tunnel syndrome symptoms without any complications. Thus, polydeoxyribonucleotide injections into the carpal tunnel can be an alternative to corticosteroid injections for carpal tunnel syndrome if there are limitations because of adverse effects of the latter.</P>

Spastic paraparesis caused by X-linked adrenoleukodystrophy mimicking vacuolar myelopathy in a human immunodeficiency virus patient : A case report

Park, Jin-Sung,Park, Donghwi Williams & Wilkins Co 2018 Medicine Vol.97 No.20

<P><B>Abstract</B></P><P><B>Rationale:</B></P><P>Vacuolar myelopathy is one of most common cause of spastic paresis in patients with human immunodeficiency virus (HIV) infection. However, X-linked adrenoleukodystrophy (X-ALD), which is a metabolic disorder caused by impairment of peroxisomal beta-oxidation of very-long-chain fatty acids (VLCFA), also manifests as various neurological deteriorations including adult onset spastic paraparesis. To the best of our knowledge, there has been no report of newly developed spastic paresis due to X-ALD in a patient with HIV infection.</P><P><B>Patient concerns:</B></P><P>A 30-year-old male had presented with progressive spastic paraparesis for 1 year.</P><P><B>Diagnosis:</B></P><P>X-ALD.</P><P><B>Intervention:</B></P><P>Brain and spine magnetic resonance imaging (MRI), VLCFA, and genetic test.</P><P><B>Outcomes:</B></P><P>His spinal MRI mimicked vacuolar myelopathy, but he was finally diagnosed with X-ALD using the VLCFA and genetic test.</P><P><B>Lessons:</B></P><P>Although rare, isolated spastic paraparesis can occur in HIV patients; additional tests such as VLCFA can be useful for the differential diagnosis. More data are needed to understand the pathological mechanisms underlying the two diseases.</P>