Effect of Family Caregiving on Depression in the First 3 Months After Spinal Cord Injury

OBJECTIVE: To investigate the effect of family caregiving on depression in the first 3 months after spinal cord injury (SCI). METHODS: A retrospective study was carried out on 76 patients diagnosed with an SCI from January 2013 to December 2016 at the Department of Physical Medicine and Rehabilitation of Kyungpook National University Hospital, Korea. Clinical characteristics including age, gender, level of injury, completeness of the injury, time since injury, caregiver information, etiology, and functional data were collected through a retrospective review of medical records. Depression was assessed using the Beck Depression Inventory (BDI). Patients with 14 or more points were classified as depressed and those with scores of 13 or less as non-depressed group. RESULTS: Of the 76 patients, 33 were in the depressed group with an average BDI of 21.27±6.17 and 43 patients included in the non-depressed group with an average BDI of 4.56±4.20. The BDI score of patients cared by unlicensed assistive personnel (UAP) was significantly higher than that of patients cared by their families (p=0.020). Univariate regression analysis showed that motor complete injury (p=0.027), UAP caregiving (p=0.022), and Ambulatory Motor Index (p=0.019) were associated with depression after SCI. Multivariate binary logistic regression analysis showed that motor completeness (p=0.002) and UAP caregiving (p=0.002) were independent risk factors. CONCLUSION: Compared with UAP, family caregivers lowered the prevalence of depression in the first 3 months after SCI.

Effects of Long-Distance Running on Cardiac Markers and Biomarkers in Exercise-Induced Hypertension Runners: An Observational Study

OBJECTIVE: To investigate changes of cardiac and muscle damage markers in exercise-induced hypertension (EIH) runners before running (pre-race), immediately after completing a 100-km ultramarathon race, and during the recovery period (24, 72, and 120 hours post-race). METHODS: In this observational study, volunteers were divided into EIH group (n=11) whose maximum systolic blood pressure was ≥210 mmHg in graded exercise testing and normal exercise blood pressure response (NEBPR) group (n=11). Their blood samples were collected at pre-race, immediately after race, and at 24, 72, and 120 hours post-race. RESULTS: Creatine kinase (CK) and cardiac troponin I (cTnI) levels were significantly higher in EIH group than those in the NEBPR group immediately after race and at 24 hours post-race (all p < 0.05). However, lactate dehydrogenase (LDH), creatine kinase-myocardial band (CKMB), or CKMB/CK levels did not show any significant differences between the two groups in each period. N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were significantly higher in EIH group than those in NEBPR group immediately after race and at 24 and 72 hours post-race (all p < 0.05). A high sensitivity C-reactive protein (hs-CRP) level was significantly higher in EIH group than that in NEBPR group at 24 hours post-race (p < 0.05). CONCLUSION: The phenomenon of higher inflammatory and cardiac marker levels in EIH group may exaggerate cardiac volume pressure and blood flow restrictions which in turn can result in cardiac muscle damage. Further prospective studies are needed to investigate the chronic effect of such phenomenon on the cardiovascular system in EIH runners.

Septic Arthritis of the Hip Joint after Pelvic Radiotherapy in Patients with Cancer: Case Report

Septic arthritis of the hip joint after radiotherapy is a rare complication with distinctive features. It is difficult to recognize this complication because of its late onset and lack of significant fever. We describe three cases of patients with septic arthritis in the hip joint who had a history of radiotherapy in the pelvic region. Our patients developed septic arthritis 1, 2, and 3 years after radiotherapy and these occurrence intervals were relatively shorter when compared to previous literature. Hip joint destruction was noted in all cases. Resection of the femoral head was required to control the infection in two cases. Careful attention is requested to detect septic arthritis when patient experiences pain in joint where underwent radiotherapy. For this case, prompt laboratory study, radiological evaluation, and joint fluid aspiration and culture are required. If there is evidence of infection in these results, a proper and immediate treatment must be started.

Analysis of Lower Extremity Contraction According to Gender Using Tensiomyography / 대한스포츠의학회지

Tensiomyography (TMG) is used to evaluate the contraction characteristics of the thigh muscles according to gender. Our hypothesis is that male's maximal displacement (Dm) will be lower than the control because the Dm increases when the muscle becomes stiff or hypertrophied. TMG evaluated 15 males and 12 females. The biceps femoris, semitendinosus, vastus lateralis, vastus medialis, and rectus femoris were evaluated. The TMG parameters obtained for each muscle were Dm and contraction time (Tc). And we calculated contraction velocity (Vc) as the rate of the radial displacement occurring during the time period of Tc with respect to Tc. Dm and Vc values of biceps femoris muscles were significantly lower in males than in controls, whereas Dm and Vc values of vastus medialis muscles were significantly lower in females than males. The Tc values of males were significantly higher in right and bilateral sum than females. This is the first report on TMG assessment by gender. We found that it is the most effective in finding muscle contraction characteristics according to gender and can induce the difference between the Dm and Vc of each muscle.

Analysis of Bodybuilder's Skeletal Muscle Characteristics Using Tensiomyography / 대한스포츠의학회지

The aim of this study is to evaluate the contractile properties of thigh muscles in bodybuilders through tensiomyography (TMG). Our hypothesis is that maximal displacement (Dm) in bodybuilders would be lower than in controls because Dm is increased when the muscle is stiffed or hypertrophied. Nine bodybuilder athletes and 15 university students were assessed by TMG. The biceps femoris (BF), semitendinosus (ST), vastus lateralis, vastus medialis (VM), and rectus femoris (RF) were evaluated. The TMG parameters obtained for each muscle were Dm, contraction time (Tc). And we calculated contraction velocity (Vc) as the rate of the radial displacement occurring during the time period of Tc with respect to Tc. Dm values of all muscles in bodybuilders were significantly higher compared to the control group. There were no significant differences in Tc values of most muscles except right BF and ST muscles. Vc values of VM, RF, and ST muscles were lower in bodybuilders than in the control group. This is the first report about TMG assessment of muscle hypertrophy. We found that Dm was most effective in detecting muscle hypertrophy and muscle stiffness secondary to muscle hypertrophy could induce decrease in Dm and Vc.

Effects of Ultra-Marathon Running on Pro-inflammatory, Anti-inflammatory and Endothelial Function Factors in Athletes with Exercise-induced Hypertension / 대한스포츠의학회지

Running for a long distance in runners with exercise-induced hypertension (EIH) increases high blood pressure (BP) which causes myocardial burden, inducing elevation of cardiac markers. It is assumed to be associated with endothelial dysfunction, but has not been studied so far. The purpose of this study is to exam the responses of anti-inflammatory, inflammatory, and endothelial regulation factors to 100 km ultra-marathon of athletes who have EIH. For this study, we obtain and analysis interleukin-6, tumor necrosis factor-α, interleukin-10 (IL-10), monocyte chemoattractant protein-1, creatine kinase and nitric oxide (NO) from 100 km ultra-marathoners before and right after the 100 km race. There were 40 volunteers who had ever won the 100 km marathon race before more than one time. They had the graded exercise test with measurement of BP for assessing EIH. Among them, eight athletes were categorized to normal control group (NCG) and 10 athletes were assessed by EIH group (EIHG). The graded exercise test with treadmill was performed for the maximal strenuous exercise and BP. EIH was diagnosed as <140/90 mm Hg in normal and ≥210 mm Hg in maximal exercise. Marathoners including EIHG (n=10) and NCG (n=8) participated in the race and blood extracted from them before the race and right after the race. As results, EIHG had lower IL-10 than NCG during resting states and after the 100 km race EIHG had significantly lower NO concentration than NCG. Therefore, the NO in the endothelial is inhibited during strenuous endurance exercise, resulting in vasoconstriction with increasing the BP.

Reference Values of Body Composition Indices: The Korean National Health and Nutrition Examination Surveys

PURPOSE: An increase in the prevalence of obesity has been observed in children and adolescents. As remarkable changes in body composition occur with growth during the adolescent period, it is important that changes in body composition be monitored. The purpose of this study was to propose reference percentile values for body composition indices including body mass index (BMI) in children and adolescents in Korea. MATERIALS AND METHODS: This study was performed using data from the Fourth and Fifth Korea National Health and Nutrition Examination Surveys. Body composition data were obtained using dual-energy X-ray absorptiometry. The percentile curves of body composition indices were constructed by the LMS method. RESULTS: A total of 2123 children and adolescents between the ages of 10 and 19 years were included in this study. We obtained the percentile curves for BMI and body composition indices. CONCLUSION: The reference values for body composition from this study could help with assessing body composition in Korean adolescents.

Effects of Balance Control Training on Functional Outcomes in Subacute Hemiparetic Stroke Patients

OBJECTIVE: To investigate the efficacy of balance control training using a newly developed balance control trainer (BalPro) on the balance and gait of patients with subacute hemiparetic stroke. METHODS: Forty-three subacute stroke patients were assigned to either a balance control training (BCT) group or a control group. The BCT group (n=23) was trained with BalPro for 30 minutes a day, 5 days a week for 2 weeks, and received one daily session of conventional physical therapy. The control group (n=20) received two sessions of conventional physical therapy every day for 2 weeks. The primary outcome was assessment with the Berg Balance Scale (BBS). Secondary outcomes were Functional Ambulation Category (FAC), the 6-minute walking test (6mWT), Timed Up and Go (TUG), the Korean version of Modified Barthel Index (K-MBI), and the manual muscle test (MMT) of the knee extensor. All outcome measures were evaluated before and after 2 weeks of training in both groups. RESULTS: There were statistically significant improvements in all parameters except MMT and FAC after 2 weeks of treatment in both groups. After training, the BCT group showed greater improvements in the BBS and the 6mWT than did the control group. CONCLUSION: Balance control training using BalPro could be a useful treatment for improving balance and gait in subacute hemiparetic stroke patients.

Change of Brain Functional Connectivity in Patients With Spinal Cord Injury: Graph Theory Based Approach

OBJECTIVE: To investigate the global functional reorganization of the brain following spinal cord injury with graph theory based approach by creating whole brain functional connectivity networks from resting state-functional magnetic resonance imaging (rs-fMRI), characterizing the reorganization of these networks using graph theoretical metrics and to compare these metrics between patients with spinal cord injury (SCI) and age-matched controls. METHODS: Twenty patients with incomplete cervical SCI (14 males, 6 females; age, 55+/-14.1 years) and 20 healthy subjects (10 males, 10 females; age, 52.9+/-13.6 years) participated in this study. To analyze the characteristics of the whole brain network constructed with functional connectivity using rs-fMRI, graph theoretical measures were calculated including clustering coefficient, characteristic path length, global efficiency and small-worldness. RESULTS: Clustering coefficient, global efficiency and small-worldness did not show any difference between controls and SCIs in all density ranges. The normalized characteristic path length to random network was higher in SCI patients than in controls and reached statistical significance at 12%-13% of density (p<0.05, uncorrected). CONCLUSION: The graph theoretical approach in brain functional connectivity might be helpful to reveal the information processing after SCI. These findings imply that patients with SCI can build on preserved competent brain control. Further analyses, such as topological rearrangement and hub region identification, will be needed for better understanding of neuroplasticity in patients with SCI.

A Novel Method for the Assessment of Muscle Injuries / 대한스포츠의학회지

Muscle injuries are very common in sports fields so diagnosis and prevention of them are as important as treatment in sports medicine. Many other devices for muscle diagnostics are provided, but non-invasiveness, cost, validity and reliability become a good measure of diagnosing and monitoring athletes. Tensiomyography (TMG) has been developed in the late 1980s to evaluate deficient muscle initially, and it was introduced into sports medicine and athletic training. It is a simple to use selective and non-invasive for measuring a skeletal muscle response. The method is based on the measurement of the radial displacement of muscle belly, which is caused by an electrical stimulator. The displacement is measured with an electric sensor which is connected to a computer system. It gives the information of maximal displacement of the belly (Dm) with following time parameters: delay time, contraction time (Tc), sustain time, and relaxation time. TMG studies usually focus on two common parameters: Tc and Dm. An increase in Tc indicates a muscle with a predominance of slow-twitch fibers. A decrease in Dm indicates an increase in muscle stiffness or tone. Other studies have been mainly associated with physiological characteristics of muscles, risk factors for muscle or ligament injuries, muscle fatigue, and muscle diseases such as multiple sclerosis. We think the application of TMG to the sports field can reduce the risk of sports injuries and increase performance of athletes. In medical field, it allows functional diagnosis of muscle strain, monitoring rehabilitation, and modifying treatment strategy effectively.

Evaluation and Application of Muscle Injuries Using Tensiomyography / 대한스포츠의학회지

Tensiomyography (TMG) is known as non-invasive method which assesses the muscular characteristics such as contraction velocity or maximal displacement of the belly. The aim of this study was to evaluate muscular responses by TMG after muscle injury and to introduce using TMG first in Korea. This study was performed with a subject who was diagnosed with muscular injury and consent measuring and following up TMG analyses. A female patient, who was diagnosed left hip adductor muscle strain, underwent magnetic resonance imaging (MRI) and TMG at intervals of two weeks. We obtained decreased in displace maximum (Dm, 4.14 vs. 5.69) and altered curve shape in the injured muscle at the initial TMG assessment in comparison to the non-injured side. After two weeks, MRI findings and symptom were improved and Dm in the injured side increased as in the non-injured muscle. These findings suggest that a decrease in Dm indicate increased in muscle stiffness after muscle injury, and an increase in Dm as in the non-injured side after two weeks indicate recovered status. TMG may be useful as a simple and non-invasive device for monitoring muscle function after muscle injury and during the recovery.

Effect of Dominant Hand Paralysis on Quality of Life in Patients With Subacute Stroke

OBJECTIVE: To evaluate the degree to which the paralysis of a dominant hand affects quality of life (QOL) in patients with subacute stroke. METHODS: We recruited 75 patients with subacute hemiplegic stroke. Patients were divided into two groups according to the location of the lesion and the side of the dominant hand. Group 1 consisted of patients whose strokes affected the dominant hand (i.e., right hemiplegia and right dominant hand or left hemiplegia and left dominant hand). Group 2 consisted of patients whose strokes affected the non-dominant hand (i.e., left hemiplegia and right dominant hand or right hemiplegia and left dominant hand). The primary outcome measure was the Short-Form 36-Item Health Survey (SF-36), which was used to evaluate health-related QOL. Secondary outcomes were scores on the Modified Barthel Index (MBI) and Beck Depression Inventory (BDI). RESULTS: We did not find any statistically significant differences between the groups in any SF-36 domain including the summaries of physical and mental component. Similarly, the MBI and BDI scores were not significantly different between the groups. CONCLUSION: The effect of paralysis on the dominant hand and QOL in patients with subacute stroke was not significantly different from the effect of paralysis on the non-dominant hand.

Exaggerated Response of Systolic Blood Pressure to Cycle Ergometer

OBJECTIVE: The aim of this study is to exam the effects of exercise modes on the systolic blood pressure and rate-pressure product during a gradually increasing exercise load from low to high intensity. METHODS: Fifteen apparently healthy men aged 19 to 23 performed the graded exercise tests on cycle ergometer (CE) and treadmill (TM). During the low-to-maximal exercises, oxygen uptake (VO2), heart rate (HR), systolic blood pressure (SBP) and rate-pressure product were measured. RESULTS: CE had a significantly lower maximum VO2 than TM (CE vs. TM: 48.51+/-1.30 vs. 55.4+/-1.19 mL/kg/min; p<0.001). However, CE showed a higher maximum SBP (SBPmax) at the all-out exercise load than TM (CE vs. TM: 170+/-2.4 vs. 154+/-1.7 mmHg; p<0.001). During the low-to-maximal intensity increment, the slope of the HR with VO2 was the same as VO2 increased in times of the graded exercise test of CE and TM (CE vs. TM: 2.542+/-0.100 vs. 2.506+/-0.087; p=0.26). The slope of increase on SBP accompanied by VO2 increase was significantly higher in CE than in TM (CE vs. TM: 1.669+/-0.117 vs. 1.179+/-0.063; p<0.001). CONCLUSION: The SBP response is stronger in CE than in TM during the graded exercise test. Therefore, there is a possibility that CE could induce a greater burden on workloads to cardiovascular system in humans than TM.

Obturator Nerve Block Using Ultrasound-guided Intraneural Alcohol Injection in Patient with Hip Adductor Spasticity

OBJECTIVE: To investigate the effects of obturator nerve blocks with ultrasound guided intraneural alcohol injection. METHOD: Nine quadriplegic patients suffering hip adductor spasticity were included in this study. The obturator nerve was identified at just below inguinal ligament area on anteromedial surface of upper leg at supine position. An 23 G needle was inserted into anterior branch of obturator nerve under real time ultrasonography. The 50% alcohol solution was injected 3~5 ml at a time within the epineurium of the anterior branch of obturator nerve until the expanding nerve was visualized. We examed modified Ashworth scale (MAS) of hip adductor and passive range of movement of hip abduction at supine position at study entry, 1, 4, and 12 weeks after ultrasound guided intraneural injection. RESULTS: There were statistically significant improvement was seen in MAS of hip adductors and hip abduction angle at 1, 4, and 12 weeks after ultrasound guided intraneural injection, compared with parameters measured at previous injection (p<0.05). CONCLUSION: Ultrasound guided intraneural alcohol injection into anterior branch of obturator nerve for treatment of hip adductor spasticity in patients with quadriplegia is an effective and safe procedure for relieving localized spasticity of the hip adductors.

The Impacts of ACE Activity according to ACE I/D Polymorphisms on Muscular Functions of People Aged 65

OBJECTIVE: To investigate associations between angiotensin-converting enzyme (ACE) polymorphisms and muscle fatigability in 65-year-old Koreans. METHOD: The study participants were 49 Koreans aged 65 years. ACE insertion/deletion (I/D) polymorphisms were determined by polymerase chain reaction and serum ACE activity, by spectrophotometry. Body mass index (BMI), body fat mass (BFM), and lean body mass (LBM) were determined. To evaluate muscle fatigability, dynamic Electromyography was used to measure maximum voluntary isometric contractions (MVICs) of ankle plantar flexor muscles. Patients were seated with their hips flexed at 90degrees, knees fully extended, and ankles at 0degrees. Continuous submaximal VICs (40% MVIC) were then performed, and contraction duration and EMG frequency changes during the initial 2 min were measured. A self-reported physical activity questionnaire was used to evaluate effects of ACE activity levels on muscle fatigability. RESULTS: Among the 49 volunteers, 15 showed II genotype; 22, ID genotype; and 12, DD genotype. Serum ACE activity levels were significantly higher in DD genotype subjects than in II genotype subjects (p<0.05). Furthermore, the duration of submaximal isometric contractions was longer in II and ID genotype subjects than in DD genotype subjects (p<0.05). Dynamic EMG showed significantly lower mean frequency changes in II genotype subjects than in DD genotype subjects (p<0.05). However, LBM, BFM, and BMI were independent of ACE genotypes. CONCLUSION: ACE II genotype subjects showed significantly higher resistant to muscle fatigue than that by DD genotype subjects. However, body composition and BMI showed no correlations with ACE I/D polymorphisms.

Feasibility and Effects of Newly Developed Balance Control Trainer for Mobility and Balance in Chronic Stroke Patients: A Randomized Controlled Trial

OBJECTIVE: To investigate the feasibility and effects of balance training with a newly developed Balance Control Trainer (BCT) that applied the concept of vertical movement for the improvements of mobility and balance in chronic stroke patients. METHOD: Forty chronic stroke patients were randomly assigned to an experimental or a control group. The experimental group (n=20) underwent training with a BCT for 20 minutes a day, 5 days a week for 4 weeks, in addition to concurrent conventional physical therapy. The control group (n=20) underwent only conventional therapy for 4 weeks. All participants were assessed by: the Functional Ambulation Categories (FAC), 10-meter Walking Test (10mWT), Timed Up and Go test (TUG), Berg Balance Scale (BBS), Korean Modified Barthel Index (MBI), and Manual Muscle Test (MMT) before training, and at 2 and 4 weeks of training. RESULTS: There were statistically significant improvements in all parameters except knee extensor power at 2 weeks of treatment, and in all parameters except MBI which showed further statistically significant progress in the experimental group over the next two weeks (p<0.05). Statistically significant improvements on all measurements were observed in the experimental group after 4 weeks total. Comparing the two groups at 2 and 4 weeks of training respectively, 10mWT, TUG, and BBS showed statistically more significant improvements in the experimental group (p<0.05). CONCLUSION: Balance training with a newly developed BCT is feasible and may be an effective tool to improve balance and gait in ambulatory chronic stroke patients. Furthermore, it may provide additional benefits when used in conjunction with conventional therapies.

External cross-validation of bioelectrical impedance analysis for the assessment of body composition in Korean adults

Bioelectrical impedance analysis (BIA) models must be validated against a reference method in a representative population sample before they can be accepted as accurate and applicable. The purpose of this study was to compare the eight-electrode BIA method with DEXA as a reference method in the assessment of body composition in Korean adults and to investigate the predictive accuracy and applicability of the eight-electrode BIA model. A total of 174 apparently healthy adults participated. The study was designed as a cross-sectional study. FM, %fat, and FFM were estimated by an eight-electrode BIA model and were measured by DEXA. Correlations between BIA_%fat and DEXA_%fat were 0.956 for men and 0.960 for women with a total error of 2.1%fat in men and 2.3%fat in women. The mean difference between BIA_%fat and DEXA_%fat was small but significant (P < 0.05), which resulted in an overestimation of 1.2 +/- 2.2%fat (95% CI: -3.2-6.2%fat) in men and an underestimation of -2.0 +/- 2.4%fat (95% CI: -2.3-7.1%fat) in women. In the Bland-Altman analysis, the %fat of 86.3% of men was accurately estimated and the %fat of 66.0% of women was accurately estimated to within 3.5%fat. The BIA had good agreement for prediction of %fat in Korean adults. However, the eight-electrode BIA had small, but systemic, errors of %fat in the predictive accuracy for individual estimation. The total errors led to an overestimation of %fat in lean men and an underestimation of %fat in obese women.

Effects of Beta-Blocker on Cardiorespiratory Fitness Factors and Blood Lipid of Patients with Acute Coronary Syndrome / 대한스포츠의학회지

The purpose of this study is to investigate effects of beta-blocker prescribed at the beginning of cardiac rehabilitation exercise for patients with acute coronary syndrome (ACS) on cardiorespiratory fitness factors and blood lipid at the 6th and the 14th week. The subjects of this study were patients (beta blocker group: n=20, non-beta blocker group: n=22) who underwent internal procedure because of ACS. The patients were conducted of exercise stress test and blood lipid before cardiac rehabilitation (the first period), were additionally prescribed of beta-blocker by cardiologist at the first week, and were conducted of exercise stress test and blood lipid at the 6th (the second period) and the 14th (the third period) week. Based on the results of this study, rest heart rate, maximal rate pressure product, sub-maximal rate pressure product, time and rate of perceived exertion showed no significant differences between groups, but peakVO2 showed interaction effect between treatment and period. All the items of blood lipid showed no differences between the groups. Conclusively, the group of beta-blocker administration showed negative effect on increase in peakVO2 at the 6th week but had positive effect at the 14th week. Meanwhile, beta-blocker did not affect blood lipid. Therefore, when patients with cardiovascular disease were additionally administered of beta-blocker at earlier period of cardiac rehabilitation, it may be needed of training time of at least six weeks to increase peakVO2.

Synchronous Large-Cell Neuroendocrine Carcinoma and Adenocarcinoma of the Colon

Large-cell neuroendocrine carcinoma of the colon is a rare entity with a prognosis that is usually poor due to the high likelihood of early metastasis. A 61-year-old man had surgery for colon cancer of the transverse colon and cecum. Microscopic examination of the tumor showed that the location was the proximal transverse colon, with small nests containing rosettes and palisading patterns of large tumor cells with faintly granular cytoplasm. The immunohistochemistry was positive for synaptophysin and chromogranins. The tumors were diagnosed as a large-cell neuroendocrine carcinoma of the colon. In addition, the tumor of the cecum showed microscopic findings consistent with a well-differentiated adenocarcinoma. The immunohistochemical panel showed that the tumor was negative for neuroendocrine markers. There were no clinical findings suggestive of hormone hypersecretion. Cancer metastasis was found in the peritoneum section of the small bowel. Postoperative chemotherapy was applied. The patient was alive with good performance after, and there was no sign of tumor progression. This is the first case of a synchronous large-cell neuroendocrine carcinoma and adenocarcinoma of the colon. The patient was treated successfully with debulking surgery and systemic chemotherapy.

Correlation between Duration of Dysphagia and Magnetic Resonance Image Findings in Patients with Stroke

OBJECTIVE: To evaluate the correlation between duration of dysphagia and magnetic resonance image (MRI) findings in patients with stroke. METHOD: Ninety seven patients, who were evaluated by video fluoroscopic swallowing studies (VFSS), were recruited for 28 months. They were divided into two groups (transient group (n=52), prolonged group (n=45)) by removing time of NG tube from onset of stroke. Their MRI findings (lesion location and lesion size) were interpreted by one experienced radiologist retrospectively. RESULTS: The duration of dysphagia had statistically significant correlation with lesion size but there was no statistically significant correlation between lesion location and duration of dysphagia in patients with stroke. Compared with transient group (51.5+/-53.8 cm3), a larger lesion was found in prolonged group (95.5+/-107.7 cm3). CONCLUSION: Lesion size, not lesion location, can be a more important factor to predict early removal of NG tube in patients with stroke. More careful interventions about dysphagia are needed in patients with larger stroke lesion.