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Spasticity is an important barrier that can hinder the restoration of function in stroke patients. Although several studies have attempted to elucidate the relationship between brain lesions and spasticity, the effects of specific brain lesions on the development of spasticity remain unclear. Thus, the present study investigated the effects of stroke lesions on spasticity in stroke patients. The present retrospective longitudinal observational study assessed 45 stroke patients using the modified Ashworth Scale to measure muscle spasticity. Each patient was assessed four times: initially (within 2 weeks of stroke) and at 1, 3, and 6 months after the onset of stroke. Brain lesions were analyzed using voxel-based lesion symptom mapping (VLSM) with magnetic resonance imaging images. Spasticity developed to a certain degree within 3 months in most stroke patients with spasticity. The VLSM method with non-parametric mapping revealed that lesions in the superior corona radiata, posterior limb of the internal capsule, posterior corona radiata, thalamus, putamen, premotor cortex, and insula were associated with the development of upper-limb spasticity. Additionally, lesions of the superior corona radiata, posterior limb of the internal capsule, caudate nucleus, posterior corona radiata, thalamus, putamen, and external capsule were associated with the development of lower-limb spasticity. The present study identified several brain lesions that contributed to post-stroke spasticity. Specifically, the involvement of white matter tracts and the striatum influenced the development of spasticity in the upper and lower limbs of stroke patients. These results may be useful for planning rehabilitation strategies and for understanding the pathophysiology of spasticity in stroke patients.

Background Exercise has an anti-inflammatory effect and reduces fat mass. Leptin has been known to be proinflammatory adipokines mainly produced by adipocytes. However, few studies have investigated the association between exercise and changes in serum leptin levels of patients with RA. This study evaluated the effect of an individualized resistance exercise on inflammatory markers including leptin as well as muscle strength and exercise capacity in patients with rheumatoid arthritis (RA). Methods A total of 42 age- and sex-matched participants were assigned to a resistance exercise program (60 min, once a week for 12 weeks, and self-exercise twice a week) or to a control group. Muscle strength, exercise capacities, and inflammatory markers such as cytokines and adipokines were assessed at baseline and at 12 weeks follow-up. Longitudinal changes in muscle strength, exercise capacity, cytokines, and adipokines between groups were tested with repeated measures analysis of variance or using the generalized estimating equation, with adjustment for baseline disease activity score 28-C response protein as a covariate. Results A total of 37 of 42 female patients with RA completed this prospective intervention study. Grip strength improved significantly in the exercise group ( P < 0.05), while no between-group changes were found. Quadriceps contraction power ( P for group-time interaction = 0.035 for the right side and P for group-time interaction = 0.012 for the left side) and 6-minute walking distance ( P for group-time interaction = 0.021) were all improved significantly in the exercise group compared with the control group. In addition, serum leptin levels were significantly decreased in the exercise group compared with the control group ( P for group-time interaction = 5.22 × 10 −5 ), but not the other cytokines or adipokines. The change in serum leptin levels correlated with the changes in fat mass (Rho = 0.491, P = 0.015) and visceral fat area (Rho = 0.501, P = 0.013). Conclusion In addition to muscle strength and exercise capacity, the 12 weeks of individualized resistance exercise reduced serum leptin levels in keeping with body fat mass or visceral fat area, suggesting that serum leptin levels might be a surrogate marker of exercise in RA.

Objectives Gait recovery is an important goal in stroke patients. Several studies have sought to uncover relationships between specific brain lesions and the recovery of gait, but the effects of specific brain lesions on gait remain unclear. Thus, we investigated the effects of stroke lesions on gait recovery in stroke patients. Materials and Methods In total, 30 subjects with stroke were assessed in a retrograde longitudinal observational study. To assess gait function, the functional ambulation category (FAC) was tested four times: initially (within 2 weeks) and 1, 3, and 6 months after the onset of the stroke. Brain lesions were analyzed via overlap, subtraction, and voxel‐based lesion symptom mapping (VLSM). Results Ambulation with FAC improved significantly with time. Subtraction analysis showed that involvement of the corona radiata, internal capsule, globus pallidus, and putamen were associated with poor recovery of gait throughout 6 months after onset. The caudate nucleus did influence poor recovery of gait at 6 months after onset. VLSM revealed that corona radiata, internal capsule, globus pallidus, putamen and cingulum were related with poor recovery of gait at 3 months after onset. Corona radiata, internal capsule, globus pallidus, putamen, primary motor cortex, and caudate nucleus were related with poor recovery of gait at 6 months after onset. Conclusion Results identified several important brain lesions for gait recovery in patients with stroke. These results may be useful for planning rehabilitation strategies for gait and understanding the prognosis of gait in stroke patients. Gait recovery is an important goal in stroke patients. Corona radiata, internal capsule, and striatum were associated with poor recovery of gait. Caudate nucleus and putamen have an important role in the recovery of the gait in patients with stroke.

Patients with stroke are known to manifest a decreased cough force, which is associated with an increased risk of aspiration. Specific brain lesions have been linked to impaired reflexive coughing. However, few studies have investigated whether specific stroke lesions are associated with impaired voluntary cough. Here, we studied the effects of stroke lesions on voluntary cough using voxel-based lesion-symptom mapping (VLSM). In this retrospective cross-sectional study, the peak cough flow was measured in patients who complained of weak cough (n = 39) after supratentorial lesions. Brain lesions were visualized via magnetic resonance imaging (MRI) at the onset of stroke. These lesions were studied using VLSM. The VLSM method with non-parametric mapping revealed that lesions in the sub-gyral frontal lobe and superior longitudinal and posterior corona radiata were associated with a weak cough flow. In addition, lesions in the inferior parietal and temporal lobes and both the superior and mid-temporal gyrus were associated with a weak peak cough flow during voluntary coughing. This study identified several brain lesions underlying impaired voluntary cough. The results might be useful in predicting those at risk of poor cough function and may improve the prognosis of patients at increased risk of respiratory complications after a stroke.

Lateropulsion (pusher syndrome) is an important barrier to standing and gait after stroke. Although several studies have attempted to elucidate the relationship between brain lesions and lateropulsion, the effects of specific brain lesions on the development of lateropulsion remain unclear. Thus, the present study investigated the effects of stroke lesion location and size on lateropulsion in right hemisphere stroke patients. The present retrospective cross-sectional observational study assessed 50 right hemisphere stroke patients. Lateropulsion was diagnosed and evaluated using the Scale for Contraversive Pushing (SCP). Voxel-based lesion symptom mapping (VLSM) analysis with 3T-MRI was used to identify the culprit lesion for SCP. We also performed VLSM controlling for lesion volume as a nuisance covariate, in a multivariate model that also controlled for other factors contributing to pusher behavior. VLSM, combined with statistical non-parametric mapping (SnPM), identified the specific region with SCP. Lesion size was associated with lateropulsion. The precentral gyrus, postcentral gyrus, inferior frontal gyrus, insula and subgyral parietal lobe of the right hemisphere seemed to be associated with the lateropulsion; however, after adjusting for lesion volume as a nuisance covariate, no lesion areas were associated with the SCP scores. The size of the right hemisphere lesion was the only factor most strongly associated with lateropulsion in patients with stroke. These results may be useful for planning rehabilitation strategies of restoring vertical posture and understanding the pathophysiology of lateropulsion in stroke patients.

Cloud/fog water samples were collected at Daekwanreung (840 m msl), a ridge site, in South Korea, from March 2002 to September 2003, by using a Caltech type, self fabricated active strand cloud water collector. The pH, electrical conductivity and major ion concentrations were analyzed. The cloud water pH ranged from 3.6 to 6.8 with an average of 5.2, which was close to the atmospheric neutral point. However, the pH calculated from average concentrations of H+ was 4.7, indicating the cloud/fog water was weakly acidified. SO^sub 4^ ^sup 2-^, NO^sub 3^ ^sup -^ and NH^sub 4^ ^sup +^ are predominant ions of which average concentrations were 203.1, 128.1, and 211.7 μeqL^sup -1^, respectively. Samples were categorized into four groups by applying 48-hour back trajectory analysis, using the HYbrid Single-Particle Largrangian Integrated Trajectory (HYSPLIT) model. Chemical compositions for the four cases significantly differed from each other. For air masses transported from the East Sea (group E), sea salt concentrations, including Na^sup +^, Cl^sup -^ Mg^sup 2+^, were relatively high. Principal acidifying pollutants, such as NO^sub 3^ ^sup -^ and nss-SO^sub 4^ ^sup 2-^, significantly increased in the case of air masses transported from the Northeast Asian continent through North Korea (group N) and air masses from the Seoul metropolitan area (group W). However, the mean pH of group N was the highest while the mean pH of group W was the lowest. This suggests that most NO^sub 3^ ^sup -^ and nss-SO^sub 4^ ^sup 2-^ in cloud/fog water was neutralized by ammonia and calcium compounds under the influence of air masses transported from Northeast Asia. N/S ratio for the group W was significantly higher than those for the other three groups, suggesting nitrogen species transported from the Seoul metropolitan area contributed to acidification of cloud/fog water at Daekwanreung. Principle Component analysis (PCA) was applied to the cloud/fog water data for presenting characteristics in the four different categories.[PUBLICATION ABSTRACT]

Rheumatoid arthritis (RA) patients may benefit from exercise for several reasons. However, whole-limb strengthening exercises for such patients remain poorly studied. We hypothesized that systemic strength training that includes the upper and lower extremities would improve strength per se and enhance the quality of life. Here, we investigated the effects of 12 weeks of upper- and lower-limb strengthening exercise on the strength and quality of life of RA patients using the International Classification of Functioning, Disability, and Health model. This was a prospective, interventional controlled trial. Forty female RA patients were recruited and assigned to two groups not based on willingness to exercise, with 20 patients in the exercise group and 20 in the control group. All patients in the exercise group received once-weekly training sessions of 60 min over 12 weeks. All participants were assessed before and after the 12-week intervention period. We measured the hand grip strength and isometric quadriceps contraction, the cross-sectional area of the rectus femoris (CSA-RF) (via ultrasonography), and performed the 30 s sit-to-stand test and the 6 min walk test (6MWT). We derived the Borg scale score after the 6MWT and assessed the extent of social participation and quality of life using a Korean version of the 36-Item Short Form Health Survey (SF-36). A total of 35 subjects completed the experiment (18 in the exercise group, 17 in the control group). After the 12-week intervention period, the lower-limb strength and the CSA-RF were significantly increased in the exercise group. The activity level did not change significantly in either group. The exercise group exhibited significant improvements in the SF-36 mental health domain scores. Thus, strengthening exercise is useful for patients with RA.

Data from a monitoring program on precipitation at four sites in South Korea during the period from 1993 to 1998 were analyzed for determining a time trend relationship in chemical composition of precipitation. The concentrations of nss-sulphate, ammonium and calcium were found to have decreased over time at a statistically significant level in Seoul (p<0.05). The concentration of nss-sulphate had declined by a rate of 12% per year for the period from 1993 to 1998. The concentrations of ammonium and calcium decreased by 11% and 12% per year respectively for the same period. The concurrent reduction of cation offsets the change in strong acid anion, thus the annual mean pH of precipitation has been approximately constant. In contrast to the rapid change of sulphate, the second most abundant anion, nitrate, showed no statistically significant decrease. As a result, the nitrate to nss-sulphate ratio (N/S ratio) has increased rapidly; the N/S ratio in precipitation has increased from less than 0.1 in 1985 to nearly 0.5 in 1998 at Seoul. In spite of the short monitoring period, a significant upward trend in the N/S ratio was also observed at all of the other sites suggesting that the nitrogen species contribute more to precipitation acidity throughout Korea.