Intensive Rehabilitation Therapy Following Brain Tumor Surgery: A Pilot Study of Effectiveness and Long-Term Satisfaction.

OBJECTIVE: To evaluate the effectiveness of intensive rehabilitation to support recovery of neurological function after brain tumor surgery and assess long-term satisfaction. METHODS: This retrospective study included patients with neurological impairment after brain tumor surgery who underwent intensive rehabilitation therapy between December 2013 and May 2017. To assess effectiveness of rehabilitation, functional outcomes (motor, cognition, and activities of daily living [ADL]) were compared between brain tumor group and a control group enrolling stroke patients who received equivalent rehabilitation during the study period. Long-term satisfaction with rehabilitation was evaluated by surveying family caregivers. RESULTS: This study included 21 patients with benign brain tumor, 14 with malignant brain tumor, and 108 with stroke. Significant and similar improvement in motor, cognition, and ADL function were noted in both the brain tumor group and the stroke group. Malignancy status did not influence the extent of functional improvement. According to medical records and surveys, 9 (69.2%) patients with malignant tumor and 2 (11.8%) with benign tumor had expired by the time of the survey. Most family caregivers confirmed that rehabilitation was effective for functional improvement (>60%), expressing overall satisfaction and stating they would recommend such therapy to patients with similar conditions (approximately 70%). CONCLUSION: Intensive rehabilitation may help promote functional improvement following brain tumor surgery regardless of malignancy compared with stroke patients. Family caregivers expressed overall satisfaction with rehabilitation at long-term follow-up. These findings support the provision of intensive rehabilitation therapy for neurologic function recovery following brain tumor surgery.

Reliability of behavioral tests in the middle cerebral artery occlusion model of rat.

Stroke is one of the leading causes of death and disability worldwide, and its incidence is increasing. To overcome impairment from stroke, translational research for developing new therapeutic technologies has been conducted and middle cerebral artery occlusion (MCAo) in rat is the representative model. Since recovery from neurological impairment in contralateral limbs caused by brain damage is the major goal of treatment, behavioral tests that assess the relevant function are used. To determine therapeutic effect, obtaining reliable results of behavioral assessment is a prerequisite. However, studies on the reliability of behavioral tests in the MCAo rat model and necessity of prior training have not yet been reported. In this study, the authors investigate relative and absolute inter-rater reliabilities of modified neurological severity score (mNSS), cylinder test, and grid-walking test before training and repeated training every week until the reliability of results reached a satisfactory level. The training included repeated learning of the scoring system and decreasing disagreements among the raters. For MCAo modeling, adult male Sprague-Dawley rats were subjected to 90 min of transient MCAo. Six raters conducted behavioral tests via observation of video-recording on sham-operated and MCAo model rats at 3 or 7 days after the intervention. An independent experimenter randomly numbered each video clip to blind the experiment. The results of reliabilities were unacceptable before training and improved to a satisfactory level after 6 weeks of training in all of the tests. In conclusion, mNSS, cylinder test, and grid-walking test on the MCAo rat model are reliable evaluation methods after conducting appropriate training.

Improved Electrochromic Characteristics of a Honeycomb-Structured Film Composed of NiO.

Color changes controlled by electronic energies have been studied for many years in order to fabricate energy-efficient smart windows. Reduction and oxidization of nickel oxide under the appropriate voltage can change the color of a window. For a superior nickel oxide (NiO) electrochromic device (ECD), it is important to control the chemical and physical characteristics of the surface. In this study, we applied polystyrene bead templates to nickel oxide films to fabricate a honeycomb-structured electrochromic (EC) layer. We synthesized uniform polystyrene beads using the chemical wet method and placed them on substrates to create honeycomb-structured NiO films. Then, the EC characteristics of the nickel oxide films with a honeycomb structure were evaluated with UV-Visible and cyclic voltammetry. FE-SEM and AFM were used to measure the morphologies of the nanostructures and the efficiencies of the redox reactions related to the specific surface area.

Needle Entry Angle to Prevent Carotid Sheath Injury for Fluoroscopy-Guided Cervical Transforaminal Epidural Steroid Injection.

OBJECTIVE: To suggest rotation angles of fluoroscopy that can bypass the carotid sheath according to vertebral levels for cervical transforaminal epidural steroid injection (TFESI). METHODS: Patients who underwent cervical spine magnetic resonance imaging (MRI) from January 2009 to October 2017 were analyzed. In axial sections of cervical spine MRI, three angles to the vertical line (α, angle not to insult carotid sheath; ß, angle for the conventional TFESI; γ, angle not to penetrate carotid artery) were measured. RESULTS: Alpha (α) angles tended to increase for upper cervical levels (53.3° in C6-7, 65.2° in C5-6, 75.3° in C4-5, 82.3° in C3-4). Beta (ß) angles for conventional TFESI showed a constant value of 45° to 47° (47.5° in C6-7, 47.4° in C5-6, 45.7° in C4-5, 45.0° in C3-4). Gamma (γ) angles increased at higher cervical levels as did α angles (25.2° in C6-7, 33.6° in C5-6, 43.0° in C4-5, 56.2° in C3-4). CONCLUSION: The risk of causing injury by penetrating major vessels in the carotid sheath tends to increase at upper cervical levels. Therefore, prior to cervical TFESI, measuring the angle is necessary to avoid carotid vessels in the axial section of CT or MRI, thus contributing to a safer procedure.

Decrement of Serum Vitamin D Level After Stroke.

OBJECTIVE: To investigate the serum vitamin D level and its determinant factors in stroke patients. METHODS: Fifty-one stroke patients who had documented serum level of 25-hydroxyvitamin D(25(OH)D) were included. Patients were divided into subacute (n=23) and chronic groups (n=28). The mean levels of 25(OH)D of the two groups were compared. Correlations between each 25(OH)D level and post-stroke duration were also analyzed. To assess other possible influencing factors, patients were subdivided by ambulation ability and feeding methods for comparison of 25(OH)D level. RESULTS: The mean level of 25(OH)D was significantly lower in the chronic group than in the subacute group (12.3 vs. 16.3 ng/mL; p<0.05). The serum 25(OH)D level decreased according to the duration after stroke (r=-0.52, p=0.01). Patients with a history of total parenteral nutrition had lower 25(OH)D levels than subjects who had enteral nutrition in the subacute group (7.3 vs. 18.8 ng/mL; p<0.01). However, the levels of 25(OH)D were not different between the oral feeding and tube feeding groups. Among the chronic group subjects, patients who could walk without assistance had higher 25(OH)D levels than non-ambulatory patients (ambulatory vs. non-ambulatory group; 18.3 vs. 11.3 ng/mL; p<0.05). CONCLUSION: After stroke onset, serum vitamin D level decreases with time regardless of feeding methods, and total parenteral nutrition may aggravate its deficiency. In terms of long-term care, non-ambulatory patients might be at a higher risk of vitamin D deficiency. Supplementation of vitamin D should be considered especially for stroke patients who are non-ambulatory and on total parenteral nutrition.

Degree of Contribution of Motor and Sensory Scores to Predict Gait Ability in Patients With Incomplete Spinal Cord Injury.

OBJECTIVE: To identify different contributions of motor and sensory variables for independent ambulation of patients with incomplete spinal cord injury (SCI), and reveal the most significant contributors among the variables. METHODS: The retrospective study included 30 patients with incomplete SCI and lesions were confirmed by magnetic resonance imaging. Motor and sensory scores were collected according to the International Standards for Neurological Classification of Spinal Cord Injury. The variables were analyzed by plotting ROC (receiver operating characteristic) curves to estimate their differential contributions for independent walking. The most significant functional determinant was identified through the subsequent logistic regression analysis. RESULTS: Motor and sensory scores were significantly different between the ambulators and non-ambulators. The majority was associated to the function of lower extremities. Calculation of area under ROC curves (AUC) revealed that strength of hip flexor (L2) (AUC=0.905, p<0.001) and knee extensor (L3) (AUC=0.820, p=0.006) contributed the greatest to independent walking. Also, hip flexor strength (L2) was the single most powerful predictor of ambulation by the logistic regression analysis (odds ratio=6.3, p=0.049), and the model fit well to the data. CONCLUSION: The most important potential contributor for independent walking in patients with incomplete SCI is the muscle strength of hip flexors, followed by knee extensors compared with other sensory and motor variables.

Method for Fabricating Textured High-Haze ZnO:Al Transparent Conduction Oxide Films on Chemically Etched Glass Substrates.

We developed a technique for forming textured aluminum-doped zinc oxide (ZnO:Al) transparent conductive oxide (TCO) films on glass substrates, which were etched using a mixture of hydrofluoric (HF) and hydrochloric (HCl) acids. The etching depth and surface roughness increased with an increase in the HF content and the etching time. The HF-based residues produced insoluble hexafluorosilicate anion- and oxide impurity-based semipermeable films, which reduced the etching rate. Using a small amount of HCl dissolved the Ca compounds, helping to fragment the semipermeable film. This formed random, complex structures on the glass substrates. The angled deposition of three layers of ZnO:Al led to the synthesis of multiscaled ZnO:Al textures on the glass substrates. The proposed approach resulted in textured ZnO:Al TCO films that exhibited high transmittance (-80%) and high haze (> 40%) values over wavelengths of 400-1000 nm, as well as low sheet resistances (< 18 Ω/sq)..Si tandem solar cells based on the ZnO:Al textured TCO films exhibited photocurrents and cell efficiencies that were 40% higher than those of cells with conventional TCO films.

Enhanced Visible Transmittance of Thermochromic VO2 Thin Films by SiO2 Passivation Layer and Their Optical Characterization.

This paper presents the preparation of high-quality vanadium dioxide (VO2) thermochromic thin films with enhanced visible transmittance (Tvis) via radio frequency (RF) sputtering and plasma enhanced chemical vapor deposition (PECVD). VO2 thin films with high Tvis and excellent optical switching efficiency (Eos) were successfully prepared by employing SiO2 as a passivation layer. After SiO2 deposition, the roughness of the films was decreased 2-fold and a denser structure was formed. These morphological changes corresponded to the results of optical characterization including the haze, reflectance and absorption spectra. In spite of SiO2 coating, the phase transition temperature (Tc) of the prepared films was not affected. Compared with pristine VO2, the total layer thickness after SiO2 coating was 160 nm, which is an increase of 80 nm. Despite the thickness change, the VO2 thin films showed a higher Tvis value (λ 650 nm, 58%) compared with the pristine samples (λ 650 nm, 43%). This enhancement of Tvis while maintaining high Eos is meaningful for VO2-based smart window applications.

Patterned Well-Aligned ZnO Nanorods Assisted with Polystyrene Monolayer by Oxygen Plasma Treatment.

Zinc oxide is known as a promising material for sensing devices due to its piezoelectric properties. In particular, the alignment of ZnO nanostructures into ordered nanoarrays is expected to improve the device sensitivity due to the large surface area which can be utilized to capture significant quantities of gas particles. However, ZnO nanorods are difficult to grow on the quartz substrate with well-ordered shape. So, we investigated nanostructures by adjusting the interval distance of the arranged ZnO nanorods using polystyrene (PS) spheres of various sizes (800 nm, 1300 nm and 1600 nm). In addition, oxygen plasma treatment was used to specify the nucleation site of round, patterned ZnO nanorod growth. Therefore, ZnO nanorods were grown on a quartz substrate with a patterned polystyrene monolayer by the hydrothermal method after oxygen plasma treatment. The obtained ZnO nanostructures were characterized by X-ray diffraction (XRD) and field-emission scanning electron microscope (FE-SEM).

Angiogenic tube formation of bovine aortic endothelial cells grown on patterns formed by H2/He plasma treatment of the plasma polymerized hexamethyldisiloxane film.

Angiogenesis, the process to generate new vessels, is necessary for normal development in children as well as the wound healing and the tumor growth in adults. Therefore, it is physiologically and/or pathophysiologically significant to monitor angiogenesis. However, classical in vitro methods to evaluate angiogenesis take a long time and are expensive. Here, the authors developed a novel method to analyze the angiogenesis in a simple and economical way, using patterned films. In this study, the authors fabricated a plasma polymerized hexamethyldisiloxane (PPHMDSO) thin film deposited by capacitively coupled plasma chemical vapor deposition system with various plasma powers. The patterned PPHMDSO film was plasma treated by 10:90 H2/He mixture gas through a metal shadow mask. The films were characterized by water contact angle, atomic force microscopy, x-ray photoelectron spectroscopy, and Fourier-transform infrared spectroscopy analyses. Our results show that the PPHMDSO film suppresses the cell adhesion, whereas surface modified PPHMDSO film enhances the cell adhesion and proliferation. From cell culture experiments, the authors found that the patterned film with 300 µm line interval was most efficient to evaluate the tube formation, a sapient angiogenic indicator. This patterned film will provide an effective and promising method for evaluating angiogenesis.

Structuring poly(3,4-ethylenedioxythiophene): poly(styrenesulfonate) towards enhancing hole collection efficiency.

To date, organic photovoltaic devices (OPVs) have obtained relatively low power conversion efficiency, mostly because of the low charge carrier mobility of the polymers to be used. This limits the optimal film thickness for efficient absorption of the solar spectrum. The capability of efficient charge carrier collections is a main factor for utilizing thick OPVs, consequently enhancing the power conversion efficiency. In this report, we demonstrate a facile approach for enhancing the hole carrier collection by possibly shortening the hole collection path via structuring poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) ( PEDOT: PSS), which is widely used as a hole collecting intermediate layer in OPVs. For structuring the PEDOT: PSS, the nanosphere lithographic method was used. Furthermore, the effects of the structuring of PEDOT: PSS on optical properties were also investigated.