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.

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.

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>

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 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>

Ultrasound-guided interventions for controlling the thoracic spine and chest wall pain: a narrative review

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

Ultrasound-guided injection is useful for managing thoracic spine and chest wall pain. With ultrasound, pain physicians perform the injection with real-time viewing of major structures, such as the pleura, vasculature, and nerves. Therefore, the ultrasound-guided injection procedure not only prevents procedure-related adverse events but also increases the accuracy of the procedure. Here, ultrasound-guided interventions that could be applied for thoracic spine and chest wall pain were described. We presented ultrasound-guided thoracic facet joint and costotransverse joint injections and thoracic paravertebral, intercostal nerve, erector spinae plane, and pectoralis and serratus plane blocks. The indication, anatomy, Sonoanatomy, and technique for each procedure were also described. We believe that our article is helpful for clinicians to conduct ultrasound-guided injections for controlling thoracic spine and chest wall pain precisely and safely.

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>