Showing papers by "Jae Young Lim published in 2013"
TL;DR: Dysphagia is a common problem among elderly people that limits some IADL domains and is the first published report of the prevalence of dysphagia in older community-dwelling Koreans.
Abstract: This study was conducted to investigate the prevalence of dysphagia and evaluated the association of dysphagia and activities of daily living in a geriatric population residing in an independent-living facility in Korea. Korean men and women 65-yr and older living in a single, typical South Korean city (n=415) were enrolled in the Korean Longitudinal Study on Health and Aging study. Dysphagia was assessed using the Standardized Swallowing Assessment. Data were collected on activities of daily living (ADL), instrumental ADL (IADL), and medical history and laboratory. The overall prevalence of dysphagia in the random sample was 33.7% (95% CI, 29.1-38.4), including 39.5% in men and 28.4% in women. The identified risk factors for dysphagia were men (OR, 3.6, P=0.023), history of stroke (OR, 2.7, P=0.042) and presence of major depressive disorder (OR, 3.0, P=0.022). Dysphagia was associated with impairment in IADL domains of preparing meals and taking medicine (P=0.013 and P=0.007, respectively). This is the first published report of the prevalence of dysphagia in older community-dwelling Koreans. Dysphagia is a common problem among elderly people that limits some IADL domains.
83 citations
TL;DR: The results showed that elastic band exercise did not appear to positively impact on blood lipids, anabolic hormones, and inflammatory cytokines, but significantly improved body composition and overall physical fitness level in the elderly.
Abstract: Elastic band exercise is considered as an effective and safe resistance type of exercise. However, there is a paucity of knowledge of the physiological effect of long-term elastic band exercise in the elderly. The purpose of this study was to examine the effects of a 12-week elastic band exercise program on body composition, physical fitness, anabolic hormones, and inflammatory cytokines in the elderly. The subjects (aged 65–82 years) were randomly assigned into the exercise group (n = 18) or the control group (n = 22). Elastic band exercise session was performed for 60 min, three times per week for 12 weeks, during which various types of resistance exercises were assigned to the exercise group using red-colored bands. Body composition was analyzed using the biolelectrical impedance measurement. Senior fitness test was adopted to determine the level of physical fitness. After 12 weeks of band exercise program, body composition and all fitness components of senior fitness test were significantly improved in the exercise group compared to the control group. In contrast, blood lipid profiles (TC, TG, and HDL), anabolic hormones (GH, IGF-1 and IGFBP-3), and inflammatory cytokines (TNF-α, IL-1β, IL-6, and CRP) were not significantly changed in the exercise group compared to the control group. Our results showed that elastic band exercise did not appear to positively impact on blood lipids, anabolic hormones, and inflammatory cytokines, but significantly improved body composition and overall physical fitness level in the elderly.
43 citations
TL;DR: Leg muscle strength remained the strong measure even after controlling for muscle mass only in women, and only large waist circumference was positively associated with functional limitation only inWomen.
Abstract: Age-related body composition changes such as sarcopenia and obesity affect functional decline in the elderly. We investigated the relationship between body composition parameters and functional limitation in older Korean adults. We enrolled 242 men and 231 women aged ≥ 65 yr from the Korean elderly cohort. We used appendicular skeletal muscle mass (ASM) divided by height(2) (ASM/Ht(2)) and ASM divided by weight (ASM/Wt). The isokinetic strength of knee extensor muscles were measured using an isokinetic device. Functional limitations were assessed using the Short Physical Performance Battery (SPPB) score less than nine. Men within the bottom tertile of ASM/Ht(2) confer an increased risk for functional limitation compared with those within the top tertile (OR, 6.24; 95% CI, 1.78-22.0). However, in women, subjects within the lowest ASM/Wt tertile had a higher risk compared with those within the highest tertile instead of ASM/Ht(2) (OR, 7.60; 95% CI, 2.25-25.7). Leg muscle strength remained the strong measure even after controlling for muscle mass only in women. Only large waist circumference was positively associated with functional limitation only in women. We might consider a different muscle index to assess functional limitation according to the gender.
40 citations
TL;DR: Muscle strength, knee pain, and BMI were important determinants of physical performance in the older population with knee osteoarthritis, and in severe knee osteOarthritis patients, muscle strength was the only significant determinant.
34 citations
TL;DR: The effects of muscle strength and muscle fat infiltration, as a measure of muscle quality, adjusted for muscle mass on femoral neck BMD in Korean elderly cohort is investigated.
Abstract: SummaryObjectives
Although muscle mass has been shown to be positively related with bone mineral density (BMD), there are only a few studies that investigated the association between muscle strength or muscle quality and BMD. We investigated the effects of muscle strength and muscle fat infiltration, as a measure of muscle quality, adjusted for muscle mass on femoral neck BMD in Korean elderly cohort.
Methods
We recruited 242 men and 231 women aged over 65 years who participated in the Korean Longitudinal Study on Health and Ageing. Leg muscle mass and femoral neck BMD were measured by dual-energy X-ray absorptiometry. Isokinetic strength of knee extensors was measured as a peak torque value by an isokinetic device. Computed tomography scan of the mid-thigh measured the mean Hounsfield unit (HU) of the lean tissue. Low bone density was defined as femoral neck T-score ≤−2·0.
Results
Leg muscle mass, knee extensor strength and thigh muscle HU values were significantly positively correlated with femoral neck BMD in both men and women. However, muscle strength was not a significant determinant for the presence of low bone mass after adjusting for muscle mass in multiple logistic regression analyses. Notably, thigh muscle HU values were strong and independent determinant for the risk of low bone density.
Conclusion
Decreased thigh muscle HU values, a measure of fatty infiltration of muscle, were independently associated with increased risk of low bone density in the elderly population.
19 citations
TL;DR: Long-term cancer survivors can benefit from the Health Partner Program to become health coaches and show greater clinically meaningful improvement in the "Think Win-Win" of SHP and in the personal strength score and total score of the PTGI.
Abstract: Background: To determine whether the Health Partner Program is effective in training long-term cancer survivors to be health coaches. Materials and Methods: We randomly assigned cancer survivors who were selected through a rigorous screening process to either the Health Partner Program or the waiting-list control group. The program consisted of 8 weeks of training in health management, leadership, and coaching. At baseline, 8, and 16 weeks, we measured primary outcomes using the Seven Habit Profile (SHP), the Korean Leadership Coaching Competency Inventory (KCCI), Ed Diner’s Satisfaction with Life Scale (SWLS), and the Posttraumatic Growth inventory (PTGI) and secondary outcomes using the Hospital Anxiety and Depression Scale (HADS), the Impact of Event Scale-Revised (IES-R), and the Medical Outcomes Study (MOS) short form 36-item questionnaire (SF36). Results: We recruited 70 subjects and randomly assigned 34 to the intervention group. The Sharpen the Saw habit of the SHP increased significantly more in intervention group than in the control group (p = 0.049), as did most PTGI factors. The intervention group also showed a significantly greater enhancement of vitality (p = 0.015) and mental health (p = 0.049) SF-36 scores but no improvement in KCCI, SWLS, HADS, or IES-R scores. The intervention group also showed a greater clinically meaningful improvement in the “Think Win-Win” of SHP (p = 0.043) and in the personal strength score (p = 0.025) and total score (p = 0.015) of the PTGI. Conclusions: Long-term cancer survivors can benefit from the Health Partner Program to become health coaches.
18 citations
TL;DR: Although the results did not show definite evidence that injection of autologous myoblast beads improves sphincter function, it was found that the dog model was suitable and reliable for studying the effects of a potential treatment modality for fecal incontinence.
Abstract: Purpose: Few studies have examined whether bioengineering can improve fecal incontinence. This study designed to determine whether injection of porous polycaprolactone beads containing autologous myoblasts improves sphincter function in a dog model of fecal incontinence. Methods: The anal sphincter of dogs was injured and the dogs were observed without and with (n = 5) the injection of porous polycaprolactone beads containing autologous myoblasts into the site of injury. Autologous myoblasts purified from the gastrocnemius muscles were transferred to the beads. Compound muscle action potentials (CMAP) of the pudendal nerve, anal sphincter pressure, and histopathology were determined 3 months after treatment. Results: The amplitudes of the CMAP in the injured sphincter were significantly lower than those measured before injury (1.22 mV vs. 3.00 mV, P = 0.04). The amplitudes were not different between dogs with and without the injection of autologous myoblast beads (P = 0.49). Resting and squeezing pressures were higher in dogs treated with autologous myoblast beads (2.00 mmHg vs. 1.80 mmHg; 6.13 mmHg vs. 4.02 mmHg), although these differences were not significant in analyses of covariance adjusted for baseline values. The injection site was stained for smooth muscle actin, but showed evidence of foreign body inflammatory reactions. Conclusion: This was the first study to examine whether bioengineering could improve fecal incontinence. Although the results did not show definite evidence that injection of autologous myoblast beads improves sphincter function, we found that the dog model was suitable and reliable for studying the effects of a potential treatment modality for fecal incontinence.
15 citations
TL;DR: East Asian patients have a low incidence of symptomatic VTE after HFS, and the clinical outcomes of patients with symptomaticVTE were similar to patients without VTE, although there was a longer rehabilitation period.
Abstract: Purpose Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a serious and life-threatening complication in elderly (older than 65 years) patients undergoing hip fracture surgery (HFS). However, few have reported on the influences of VTE on postoperative rehabilitation in these patients. This study was performed to determine whether VTE affects clinical outcomes in patients who underwent HFS. Materials and methods We retrospectively evaluated 330 HFSs in 325 consecutive patients, which were performed from January 2009 to June 2010. From chart review, we identified 15 patients with symptomatic VTE. We compared Geriatric depression scale, Modified Barthel index and Berg balance scale scores as well as 10 meter gait speed at discharge and hospital stay between a symptomatic VTE group and a non-VTE group. Results No significant difference in clinical outcomes at discharge between the two groups was found, although hospital stay was longer in patients with symptomatic VTE (p=0.012). Conclusion East Asian patients have a low incidence of symptomatic VTE after HFS, and the clinical outcomes of patients with symptomatic VTE were similar to patients without VTE, although there was a longer rehabilitation period.
12 citations
TL;DR: An animal model of OSA could be developed by paralyzing the genioglossus in rabbits and may contribute to identifying the pathogenesis of upper airway obstruction in OSA and to developing new diagnostic or treatment devices targeting specific obstruction sites.
Abstract: Importance This study presents an innovative method for developing a neuromuscular model of obstructive sleep apnea (OSA). Objective To establish a new OSA animal model simulating real upper airway conditions during sleep. Design and Setting In vivo animal study at an academic tertiary referral center. Subjects A total of 27 New Zealand white male rabbits were used. Intervention Sleep was induced by intramuscular injection of 0.3 mL/kg of tiletamine hydrochloride plus zolazepam hydrochloride and 0.2 mL/kg of xylazine. Upper airway obstruction was induced by injecting botulinum toxin type A (2.5 U in 8 rabbits, 5.0 U in 10 rabbits, and 7.5 U in 1 rabbit) into the genioglossus. Eight rabbits were injected with normal saline as a control. Main Outcomes and Measures Drug-induced sleep was evaluated using a portable polysomnography device for electroencephalography, electrooculography, chin electromyography, nasal airflow, breathing efforts, and pulse oxymetry. Respiratory events (apneas or hypopneas) during sleep were evaluated using a sleep-screening tool. Results All the rabbits showed no apneas or hypopneas before injection of botulinum toxin type A. In the control rabbits injected with normal saline, apneas or hypopneas were not found. The respiratory events were observed in 5 of 8 rabbits injected with 2.5 U of botulinum toxin type A, whereas they were observed in 7 of 10 rabbits injected with 5.0 U of botulinum toxin type A. The median (interquartile range) apnea hypopnea index was 9.6 (5.3-14.8) per hour and 45.6 (21.5-70.5) per hour in the rabbits injected with 2.5 U and 5.0 U of botulinum toxin type A, respectively ( P = .03). Conclusions and Relevance An animal model of OSA could be developed by paralyzing the genioglossus in rabbits. This model may contribute to identifying the pathogenesis of upper airway obstruction in OSA and to developing new diagnostic or treatment devices targeting specific obstruction sites.
11 citations
TL;DR: Management of shoulder pain in the elderly depends on not only an accurate diagnosis of etiologies and appropriate treatments according to clinical characteristics, but also understanding that the mechanisms of developing those diseases were closely related to the degenerative changes with age.
Abstract: Shoulder pain is a common problem in the elderly, which can frequently lead to disabilities. Adhesive capsulitis, rotator cuff disease, and osteoarthritis are main causes of shoulder pain in the elderly. Because the use of the upper extremity is especially pertinent to maintain independence in the elderly, proper management of shoulder pain is crucial to preserve or restore functional independence by reducing the degree of pain as much as possible. Successful treatment of shoulder pain in the elderly depends on not only an accurate diagnosis of etiologies and appropriate treatments according to clinical characteristics, but also understanding that the mechanisms of developing those diseases were closely related to the degenerative changes with age.
9 citations
TL;DR: To the Editor: The authors found an error in their published article and have fixed it.
Abstract: To the Editor:
We found an error in our published article.
Kim JH, Choi SH, Lim S, Yoon JW, Kang SM, Kim KW, Lim JY, Cho NH, Jang HC. Sarcopenia and Obesity: Gender-Different Relationship with Functional Limitation in Older Persons. J Korean Med Sci 2013;28(7):1041-1047.
The legends of Fig. 1 were marked incorrectly. The correct legends are below.
TL;DR: The authors failed to establish a rat spinal cord stimulation model, however, sacral neuromodulation have a therapeutic potential to improve neurogenic bladder and muscle atrophy.
Abstract: Objective: The purpose of this study is to compare a neuroprotective effect of thoracic cord neuromodulation to that of sacral nerve neuromodulation in rat thoracic spinal cord injury (SCI) model. Methods: Twenty female Sprague Dawley rats were randomly divided into 4 groups: the normal control group (n=5), SCI with sham stimulation group (SCI, n=5), SCI with electrical stimulation at thoracic spinal cord (SCI + TES, n=5), and SCI with electrical stimulation at sacral nerve (SCI + SES, n=5). Spinal cord was injured by an impactor which dropped from 25 mm height. Electrical stimulation was performed by the following protocol: pulse duration, 0.1 ms; frequency, 20 Hz; stimulation time, 30 minutes; and stimulation duration at thoracic epidural space and S2 or 3 neural foramina for 4 weeks. Locomotor function, urodynamic study, muscle weights, and fiber cross sectional area (CSA) were investigated. Results: All rats of the SCI + TES group expired within 3 days after the injury. The locomotor function of all survived rats improved over time but there was no significant difference between the SCI and the SCI + SES group. All rats experienced urinary retention after the injury and recovered self-voiding after 3-9 days. Voiding contraction interval was 25.5±7.5 minutes in the SCI group, 16.5±5.3 minutes in the SCI+SES group, and 12.5±4.2 minutes in the control group. The recovery of voiding contraction interval was significant in the SCI + SES group comparing to the SCI group (p<0.05). Muscle weight and CSA were slightly greater in the SCI + SES than in the SCI group, but the difference was not significant. Conclusion: We failed to establish a rat spinal cord stimulation model. However, sacral neuromodulation have a therapeutic potential to improve neurogenic bladder and muscle atrophy.
TL;DR: A new hypothesis of ‘altered neuromuscular control’, which has been documented recently, is introduced and introduced as a part of the reason in old adults for muscle cramps.
Abstract: Muscle cramps are defined as painful, spasmodic, involuntary skeletal muscle contractions during or immediately after physical exercise. Muscle cramps have a typical clinical presentation, as the definition and the diagnosis is made based on a typical history together with the findings on clinical examination. Muscle cramps are self-extinguishing within seconds to minutes or relieved by stretching, and is often accompanied by a palpable knotting of the muscle. Old adults are prone to get muscle cramps, which may occur in patients with diseases, but also occur often in healthy subjects with no history of nervous system or metabolic disorders. Comorbidity and multiple medications, including diuretics due to an underlying disease, can be a part of the reason in old adults. We reviewed articles regarding the etiology of muscle cramps and introduced a new hypothesis of ‘altered neuromuscular control’, which has been documented recently.
TL;DR: Poster 113 Ophthalmoplegia with Late Onset Oropharyngeal Weakness in Miller Fisher Syndrome, A Rare Variant of Guillain-Barré Syndrome: A Case Report.
Abstract: Poster 113 Ophthalmoplegia with Late Onset Oropharyngeal Weakness in Miller Fisher Syndrome, A Rare Variant of Guillain-Barré Syndrome: A Case Report. Rakhi Garg Sutaria, MD; Michelle Stern, MD (Jacobi Medical Center/University for Albert Einstein College of Medicine, NY); Rakhi G. Sutaria (Montefiore Medical Center at University for Albert Einstein Medical Center, Bronx, NY, United States); Michelle Stern, MD.
Journal Article•