Relationship between serum alkaline phosphatase level,C-reactive protein and leukocyte counts in adults aged 60 years or older

Serum alkaline phosphatase (ALP), a useful marker of hepatobiliary or bone disorders, has been known to be associated with cardiovascular disease (CVD), which is increasingly being viewed as an inflammatory disease. C-reactive protein level and leukocyte count have also been highlighted as independent risk markers of CVD. Thus, the mechanism underlying the link between elevated ALP and CVD could be subclinical low-grade inflammation. This study aimed to examine associations of serum ALP level with inflammatory markers. This cross-sectional study included 2403 participants (1324 men and 1079 women) aged ≥60 years who participated in a health examination program. Serum ALP quartiles were categorized as follows: Q1: ≤51, Q2: 52–61, Q3: 62–74 and Q4: ≥75?U/L. The odds ratios (ORs) and 95% confidence intervals (CIs) for high CRP and leukocyte count (≥75th percentiles) were calculated after adjusting for confounding variables across serum ALP quartiles using multiple logistic regression analysis. Median CRP level and mean leukocyte count increased in accordance with serum ALP quartiles. Compared to the lowest quartile, the ORs (95% CI) of the highest quartile for high CRP and leukocyte count were 2.03 (1.50–2.76) and 1.54 (1.13–2.10) after adjusting for age, sex, body mass index, smoking status, alcohol intake, fasting plasma glucose, log-transformed triglyceride and HDL-cholesterol levels. Serum ALP level was positively and independently associated with inflammatory markers in adults aged 60 years or older.     

A case of primary hepatic actinomycosis: an enigmatic inflammatory lesion of the liver

Primary hepatic actinomycosis is one of the chronic abscess-forming infections of the liver. Accurate diagnosis is frequently delayed due to its indolent course and nonspecific clinical and radiological manifestations. We report a case of a 57-year-old man presenting with asymptomatic multiple hepatic masses on follow-up abdominal computed tomography performed 1 year after stomach cancer surgery. Although a percutaneous liver biopsy procedure was conducted twice in order to obtain confirmative pathology, only a nonspecific organizing abscess with plasma cell infiltration was revealed, without identification of any organism in the tissue cultures. Ultimately, actinomycosis was diagnosed following the detection of sulfur granules on open surgical biopsied tissue. This case suggests that primary hepatic actinomycosis should be considered as one of the possible causes for enigmatic inflammatory lesions of the liver.     

Effect of spatial target reaching training based on visual biofeedback on the upper extremity function of hemiplegic stroke patients

[Purpose] The aim of this study was to determine the effect of spatial target reaching training (TRT) based on visual biofeedback (VB) on the upper extremity (UE) function of hemiplegic subjects. [Subjects and Methods] Forty subjects between six and eighteen months post-stroke were enrolled in this study. They were randomly allocated to an experimental group (EG, n=20) and a control group (CG, n=20). All subjects received an hour of routine therapy for stroke three times a week for four weeks. Subjects in EG received additional spatial TRT based on VB using a 2-dimensional motion capture analysis system. Both groups were tested at pre and post-intervention. The motor function of each subject’s UE was assessed using the Fugl-Meyer (FM) test of UE and the Wolf Motor Function Test (WMFT). The reaching speed, angle and maximum reach distance were recorded using the motion capture analysis system. The experimental data were analyzed using the paired and independent t-tests. [Results] The mean change scores of the FM Test of UE and WMFT show there was significantly more improvement at post-intervention in EG than in CG. Also, the speed and angle reached showed significantly more increase in the EG compared with the CG. [Conclusions] The findings indicate that UE motor recovery of hemiplegic stroke patients can be enhanced through the use of TRT based on VB.Key words: Target reaching training, Upper extremity function, Visual biofeedback     

The effects of backpack loads and spinal stabilization exercises on the dynamic foot pressure of elementary school children with idiopathic scoliosis

[Purpose] The purpose of this study was to measure and observe the changes in dynamic plantar pressures when school children carried specific bag loads, and to determine whether improved physical balance after an eight-week spinal stabilization exercise program can influences plantar pressures. [Subjects] The subjects were 10 school students with Cobb angles of 10° or greater. [Methods] Gait View Pro 1.0 (Alfoots, Korea) was were based on to measure the pressure of the participants’ feet. Spinal stabilization exercises used TOGU Multi-roll Functional (TOGU, Germany) training. Dynamic plantar pressures were measured with bag loads of 0% no bag and 15% of subjects’ body weight. The independent t test was performed to analyze changes in plantar pressures. [Results] The plantar pressure measurements of bag load of 0% of subjects’ body weight before and after the spinal stabilization exercise program were not significantly different, but those of two foot areas with a 15% load were statistically significant (mt5, 67.32±24.25 and 51.77±25.52 kPa; lat heel, 126.00±20.46 and 102.08±23.87 kPa). [Conclusion] After performance of the spinal stabilization exercises subjects’ overall plantar pressures were reduced, which may suggest that physical balance improved.Key words: Idiopathic scoliosis, Dynamic foot pressure, Backpack load     

Effects of bilateral training on motor function,amount of activity and activity intensity measured with an accelerometer of patients with stroke

[Purpose] This study investigated the recovery of arm function and the functional use of the affected limb in real life of stroke patients after bilateral arm training. [Subjects] Twenty patients with stroke were randomly allocated to the BT (bilateral training group, n=10) and UT (unilateral training group, n=10) groups. [Methods] The BT group performed functional tasks with both hand symmetrically, the UT group performed tasks with only the affected hand for 30 minutes a session 5 times a week over 6 weeks. Before and after the intervention, accelerometers (Actisleep), functional independence measure (FIM) and manual function test (MFT) were used to assess subjects’ abilities. [Results] The BT group showed a significant improvement in FIM total score, motor subtotal score and MFT score of affected side compared to the UT group. The BT group showed a more quantitative increase in the amount of activity of the affected side than the UT group. Regarding activity intensity, the BT group showed a decrease in the sedentary level and an increase of the moderate level on the affected side compared to the UT group. [Conclusion] We found that programs tailored to the characteristics of stroke patients and continuous monitoring of physical activity using an accelerometer minimized possible future disability and improved the patients’ quality of life.Key words: Accelerometers, Bilateral training, Stroke     

Risk Factors for Recurrence after Successful Treatment of Mycobacterium avium Complex Lung Disease

This study analyzed the recurrence rate and risk factors for recurrence of Mycobacterium avium complex (MAC) lung disease in patients successfully treated for this disease. The medical records of 158 patients successfully treated for MAC lung disease at a tertiary referral center in South Korea between March 2000 and December 2009 were retrospectively analyzed. Recurrence was recorded, and factors associated with recurrence were analyzed. The mean age of the 158 patients was 60.7 ± 11.1 years. The etiologic agent was Mycobacterium avium in 77 patients (48.7%) and Mycobacterium intracellulare in 81 patients (51.3%). Radiographic features included nodular bronchiectatic disease in 95 (60.1%), fibrocavitary disease in 49 (31.0%), and an unclassifiable form in 14 (8.9%) patients. Almost all (98.7%, 156/158) patients had been previously treated with a macrolide-containing regimen, and 68 (43.0%) patients had received treatment with an aminoglycoside. During a median follow-up of 43.8 months after completion of therapy, 50 patients (31.6%) experienced recurrence, at a median of 11.9 months after treatment completion. Multivariate analysis showed that only the nodular bronchiectatic form of the disease (hazard ratio, 2.39; 95% confidence interval, 1.19 to 4.81) was independently associated with an increased risk of recurrence. Recurrence after successful treatment is frequent in patients with MAC lung disease. The recurrence rate was significantly higher in patients with the nodular bronchiectatic form than in those with the fibrocavitary form or an unclassifiable form of the disease.     

The effect of superficial trunk muscle exercise and deep trunk muscle exercise on the foot pressure of healthy adults

[Purpose] The purpose of this study was to analyze the effect of superficial trunk muscle exercise and deep trunk muscle exercise on the foot pressure of healthy adults. [Subjects] The subjects were 30 healthy females and males who agreed to participate in this study. There were two groups, a superficial trunk muscle exercise group and a deep trunk muscle exercise group, with 15 participants in each. [Methods] The exercises were conducted 5 times a week for 4 weeks for both groups. A gait analyzer was used to measure foot plantar pressure while walking on a plate. Participants were measured before starting the exercise and after 4 weeks. The paired t-test was used to analyze the pre-and post-test results. [Results] There were no significant differences in foot pressure in any region in the superficial trunk muscle exercise group. In the deep trunk muscle exercise group, there were statistically significant increase in F1, F4, F5, R1 and R3. In addition, there were significant decreases in R2 and R4. [Conclusion] After the 4-week deep trunk muscle exercise group decreases in foot pressure on the inner foot and increases on the outside of the feet indicate normal and overall even distribution of body weight on the feet.Key words: Superficial trunk muscle exercise, Deep trunk muscle exercise, Foot pressure     

Alpha-antitrypsin genotypes in Korean patients with chronic obstructive pulmonary disease

OBJECTIVE: Alpha1-antitrypsin (AAT) deficiency is a recognized susceptible factor for chronic obstructive pulmonary disease (COPD) in Western countries, but its importance in Korea is unclear. To date, no definitive case of alpha1-antitrypsin deficiency has been reported in Korea. This study aimed to clarify whether alpha1-antitrypsin deficiency exists and to determine the distribution of alpha1-antitrypsin alleles in the Korean population. METHODOLOGY: The serum concentrations of alpha1-antitrypsin were determined and polymorphisms of the alpha1-antitrypsin gene in 114 COPD patients and in 196 healthy controls were examined. Phenotyping by isoelectric focusing and the genotyping of alpha1-antitrypsin gene by polymerase chain reaction and restriction fragment length polymorphism were performed. RESULTS: No alpha1-antitrypsin level abnormality was found in the patients. M1(Val)/M1(Val) was found to be the most frequent genotype in both groups (69.2% and 66.8%, respectively), and M1(Val) the most frequent allele. The distributions of alpha1-antitrypsin alleles were similar in the patient and control groups, and no S or Z allele was found. CONCLUSION: Alpha1-antitrypsin deficiency is unlikely to be an important cause of chronic obstructive pulmonary disease in the Korean population.