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.

The effectiveness of 2 consecutive intra-articular polydeoxyribonucleotide injections compared with intra-articular triamcinolone for hemiplegic shoulder pain

Park, Donghwi,Yu, Kwang Jae,Cho, Ju Young,Woo, Seung Beom,Park, Junu,Lee, Zeeihn,Kim, Jong Min,Jellad., Anis Williams & Wilkins Co 2017 Medicine Vol.96 No.46

<P><B>Abstract</B></P><P>The aim of this study was to investigate the effects of intra-articular injection of polydeoxyribonucleotide (PDRN), compared with intraarticular triamcinolone (TA) injection, in subacute stroke patients with hemiplegic shoulder pain (HSP).</P><P>Participants were subacute stroke patients with HSP who had undergone 2 consecutive intra-articular injections of TA or PDRN.</P><P>Numeric rating scale (NRS) and passive range of motion (PROM) of hemiplegic shoulder were evaluated until 4 weeks after 2nd injection.</P><P>In the results, there were significant improvements in all PROM measures 2 weeks after the second injection, compared with pre-injection results, in both groups (<I>P</I> < .05). In the PDRN group, however, none of the PROM measures were significantly improved at 3 and 4 weeks after the second injection, compared with pre-injection results (<I>P</I> ≥ .05). When comparing pre-injection results with those at 4 weeks after the second injection, all PROM and NRS measures in the TA group were more improved than in the PDRN group, but this was not statistically significant (<I>P</I> ≥ .05).</P><P>In conclusion, considering the systemic side effects of steroids, especially among patients with diabetes or metabolic syndrome, PDRN seems to be a worthwhile treatment option for HSP, although PDRN does not seem to have an equivalent persistence effects when compared with TA.</P>

Dilemmas Within the Korean Health Insurance System

Park, Donghwi,Chang, Min Cheol The Korean Society for Preventive Medicine 2020 Journal of Preventive Medicine and Public Health Vol.53 No.4

The health insurance system in Korea is well-established and provides benefits for the entire national population. In Korea, when patients are treated at a hospital, the hospital receives a partial payment for the treatment from the patient, and the remaining amount is provided by the health insurance service. The Health Insurance Review and Assessment Service (HIRA) assesses whether the treatment was appropriate. If HIRA deems the treatment appropriate, the doctor can receive payment from the health insurance service. However, this system has several drawbacks. In this study, we aimed to provide examples of the problems that can occur in relation to HIRA assessments in Korea through actual clinical cases.

Different characteristics of ventilator application between tracheostomy- and noninvasive positive pressure ventilation patients with amyotrophic lateral sclerosis

Park, Donghwi,Lee, Goo Joo,Kim, Ha Young,Ryu, Ju Seok Wolters Kluwer Health 2017 Medicine Vol.96 No.10

<P><B>Abstract</B></P><P>The aim of the study was to investigate the appropriate home ventilator settings for patients with amyotrophic lateral sclerosis (ALS).</P><P>In total, 71 patients with ALS, who had received either a noninvasive positive pressure ventilation (NIPPV) or tracheostomy positive pressure ventilation (TPPV), were included. Accordingly, patients were divided into 2 groups (the TPPV and NIPPV groups). We retrospectively evaluated the values used in home ventilators for patients with ALS, who had maintained a stable level of CO<SUB>2</SUB> on both the arterial blood gas analysis (ABGA) and transcutaneous blood gas monitoring. To measure the main outcome, we also investigated the actual body weight (ABW) and predicted body weight (PBW) of patients, and the following setting values of ventilators were also recorded: the inspired tidal volume (<I>V</I><SUB>Ti</SUB>), minute ventilation (MV), peak inspiratory pressure (PIP), positive end expiratory pressure (PEEP), and inspiratory time (<I>T</I><SUB>ins</SUB>).</P><P><I>V</I><SUB>Ti</SUB> and MV showed a significantly positive correlation with both PBW and ABW of patients in the TPPV group. However, both <I>V</I><SUB>Ti</SUB> and MV had greater significant correlation with PBW than ABW in the TPPV group. In addition, <I>V</I><SUB>Ti</SUB> and MV did not show a significantly positive correlation with either PBW or ABW in the NIPPV group.</P><P>In patients with ALS, PBW was more useful for predicting <I>V</I><SUB>Ti</SUB> and MV than ABW. Moreover, it will be helpful to know the differences of setting values between TPPV and NIPPV, especially because ALS patients are usually treated with TPPV due to the initial difficulties associated with NIPPV.</P>

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>

Diastolic heart dysfunction is correlated with CTG repeat length in myotonic dystrophy type 1

Park, Jin-Sung,Kim, Namkyun,Park, Donghwi Springer-Verlag 2018 Neurological sciences Vol.39 No.11

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>

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>

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>

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.