Pathological laughing and crying(PLC) is a condition that is characterized by episodic, brief, contextually inappropriate, uncontrollable outbursts of laughing and/or crying. It can be observed in patients with various neurological disorders. PLC often causes distress in interpersonal functioning and activities for patients and their families. PLC can be recognized easily with proper understanding of the condition and its nature. Also it generally shows good response to various pharmacological treatments. This review aims to encourage the diagnosis and treatment of PLC by providing definition and clinical presentation of PLC, analysis of its pathophysiology and various current treatment options.
Crying* ; Diagnosis ; Humans ; Nervous System Diseases

Traumatic brain injury (TBI) is well recognized as a disability category with high incidence and prevalence as well as considerable impact on survivors and their families. Neuropsychiatric symptoms such as cognitive deficit, psychosis, depression, mania, anxiety are common after TBI. Treatment of the neuropsychiatric symptoms associated with TBI should result in decreased handicap, improved quality of life, and decreased societal impact. This article discusses the clinical approach to treating patients with neuropsychiatric complications following TBI.
Anxiety ; Bipolar Disorder ; Brain ; Brain Injuries ; Depression ; Humans ; Incidence ; Prevalence ; Psychotic Disorders ; Quality of Life ; Survivors

No abstract available.
Trophoblastic Neoplasms* ; Trophoblasts*

PURPOSE: The purpose of this study was to investigate the degree of performance of TB control manpower in Korea and to identify the affecting factors associated with it. METHODS: This study employed a quantitative observational with cross-sectional design and the subjects were consisted of 189 TB (Tuberculosis) control manpower who were working in both community health centers and private hospitals. Variables included in this study were demographic, social, work-related characteristics, aqhnd self-efficacy. A reliability of the instrument for the performance was Cronbach's alpha=.91. Data were analyzed by t-test, ANOVA and multiple regression using SPSS (19th version). RESULTS: The mean value of the degree of work-related performance of TB control manpower was 4.4+/-0.49 and it was higher than those of general nurses working in any other health care departments. The mean differences in the degree of work-related performance were in self-efficacy, workplace, the number of full charge manpower in TB, the number of participation in in-depth education, and the willingness to job maintenance. In multiple regression analysis, factors associated with TB control manpower' work-related performance were self-efficacy (beta =.164, p=.025), workplace (beta=-.186, p=.023), the number of participation in in-depth education(beta=.339, p<.002), and the willingness to job maintenance (beta=-.157, p=.036). CONCLUSION: Results of this study showed that work-related performances of manpower working in private hospital were higher than those of manpower in public health centers. So, it is necessary to enhance nation's active intervention to improve effectiveness and reduction of risk factors in TB policy.
Community Health Centers ; Delivery of Health Care ; Education ; Hospitals, Private ; Korea ; Public Health ; Risk Factors ; Self Efficacy ; Tuberculosis

PURPOSE: The purpose of this study was to investigate the degree of performance of TB control manpower in Korea and to identify the affecting factors associated with it. METHODS: This study employed a quantitative observational with cross-sectional design and the subjects were consisted of 189 TB (Tuberculosis) control manpower who were working in both community health centers and private hospitals. Variables included in this study were demographic, social, work-related characteristics, aqhnd self-efficacy. A reliability of the instrument for the performance was Cronbach's alpha=.91. Data were analyzed by t-test, ANOVA and multiple regression using SPSS (19th version). RESULTS: The mean value of the degree of work-related performance of TB control manpower was 4.4+/-0.49 and it was higher than those of general nurses working in any other health care departments. The mean differences in the degree of work-related performance were in self-efficacy, workplace, the number of full charge manpower in TB, the number of participation in in-depth education, and the willingness to job maintenance. In multiple regression analysis, factors associated with TB control manpower' work-related performance were self-efficacy (beta =.164, p=.025), workplace (beta=-.186, p=.023), the number of participation in in-depth education(beta=.339, p<.002), and the willingness to job maintenance (beta=-.157, p=.036). CONCLUSION: Results of this study showed that work-related performances of manpower working in private hospital were higher than those of manpower in public health centers. So, it is necessary to enhance nation's active intervention to improve effectiveness and reduction of risk factors in TB policy.
Community Health Centers ; Delivery of Health Care ; Education ; Hospitals, Private ; Korea ; Public Health ; Risk Factors ; Self Efficacy ; Tuberculosis

PURPOSE: Interleukin-17-producing T cell (Th17 cell) is a newly discovered subtype of helper T cell. Its function and importance in the pathogenesis of a broad range of immune diseases are under active investigation. However, little is currently known about the role of Th17 cells in ischemia-reperfusion (IR) injury of the kidney, a common pathophysiologic occurrence in various renal disease processes. METHODS: We measured the number of infiltrated T lymphocytes and Th17 cells in C57Bl/6 mouse kidneys in sham-operated controls and following varying degrees of renal IR injury induced by renal pedicle clamping and reperfusion. The cell count results were compared to accompanying histologic damage and serum creatinine levels after 35 min and 45 min of ischemia, and following reperfusion of 48, 72, 96, and 168 hrs. RESULTS: The number of T lymphocytes increased as ischemia time increased. However, the number of Th17 cells was not significantly affected by prolonged ischemia and reperfusion. Furthermore, the degree of histologic damage and serum creatinine levels did not correlate with the T lymphocyte and Th17 cell count numbers. CONCLUSION: We did not observe any evidence that Th17 cells are directly linked to renal tissue damage caused by IR injury. The role and importance of helper T cells in renal IR injury need to be evaluated further in the light of the interaction with Th1, Th2, and regulatory T cells rather than Th17 alone.
Acute Kidney Injury ; Animals ; Cell Count ; Constriction ; Creatinine ; Immune System Diseases ; Ischemia ; Kidney ; Light ; Lymphocytes ; Mice ; Reperfusion ; Reperfusion Injury ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer ; T-Lymphocytes, Regulatory ; Th17 Cells

PURPOSE: In the emergency department (ED), there are many cases of routine emergent endoscopic evaluation for patients who ingest liquid household bleach containing sodium hypochlorite. Many researchers have recommended endoscopic evaluation for caustic injury, but there is much controversy over the indication for emergent endoscopy. Because the clinical course of patients who ingest sodium hypochlorite is commonly mild, we investigated the necessity for routine emergent endoscopy. METHODS: We included patients who visited the ED due to ingestion of liquid bleach containing sodium hypochlorite during the 4 years from June 2001 to May 2005. We retrospectively reviewed the demographic characteristics, ingested amount, symptoms and signs, disposition, and endoscopic results. We also tried to find relationships between the variables and the final endoscopic results. RESULTS: Of the 63 patients included in this study, 47 underwent emergent endoscopy in the ED. The endoscopic results were Grade 1 in 31 patients, Grade 2a in 13, Grade 2b in 2, and Grade 3a in 1. Clinically significant results were observed in only 3 (6.4%) cases. The symptoms and signs was not related to the endoscopic results, but diluted ingestion and the amount of ingestion (<100ml) were significantly related to the endoscopic severity. CONCLUSION: The indications for emergent EGD (esophagogastroduodenoscopy) for caustic injury were discussed. In almost all cases, however, the clinical course of the patients ingesting the sodium hypochlorite was not significant. If the patient ingests a small amount of diluted liquid bleach, < 100 ml, and has few symptoms and signs, we recommend follow up in the outpatient department, which will reduce unnecessary emergent endoscopy.
Caustics ; Eating ; Emergency Service, Hospital ; Endoscopy* ; Family Characteristics* ; Follow-Up Studies ; Humans ; Outpatients ; Retrospective Studies ; Sodium Hypochlorite* ; Sodium*

STUDY DESIGN: We retrospectively reviewed nine patients of lumbar extraforaminal disc herniation which underwent conservative or surgical treatment. OBJECTIVES: We evaluated the clinical characteristics, accuracy of diagnostic methods, and result of conservative or surgical treatment for the lumbar extraforaminal disc herniation. SUMMARY OF BACKGROUND DATA: Lumbar extraforaminal disc herniation represents an important component of lumbar disc herniation because of the difficulty in diagnosis and the difference in clinical characteristics and surgical approaches in contrast to usual intracanalicular disc herniation. MATERIALS AND METHODS: Nine patients which we have experienced from March 1994 to February 1997 were evaluated by physical examination, magnetic resonance imaging, EMG, and disco-enhanced computed tomogram. There were 4 males and 5 females, and average age was 42.4 years. RESULTS: The level of herniation was 4 cases at L4-5 and 5 at L5-S1. Radiating pain was chief complaint but low back pain was absent or mild. Accuracy of disco-enhanced computed tomogram was superior to that of magnetic resonance imaging. The results of conservative treatment were good in 2 cases(40%), fair in 2 cases(40%), and poor in 1 case(20%). And those of surgical treatment including partial laminectomy, medial facetectomy, and discectomy or extraforaminal approach were excellent in 3 cases(75%), good in 1 case(25%) according to the grading of MacNab. CONCLUSIONS: Lumbar extraforaminal disc herniation represents compressive symptoms of upper lumbar root of the involved level characteristically. Location and degree of disc herniation is an important tractor for determining the surgical approach, and disco-enhanced computed tomogram is a definite diagnostic method.
Diagnosis* ; Diskectomy ; Female ; Humans ; Laminectomy ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Physical Examination ; Retrospective Studies

PURPOSE: Air bubbles developed during phcoemulsification procedure are known to be harmful to corneal endothelial cells and balanced salt solution(BSS) contained within plastic bag(Bag BSS) has been thought to be more prone to the air bubble formation than the one encased within bottle(Bottle BSS). For the above reason, we tried to see whether there is any difference in corneal endothelial cell changes between two groups of patients who underwent phacoemulsification using Bag BSS and Bottle BSS respectively. METHODS: 85 cataract eyes of 60 patients were randomly assigned to two groups of Bag BSS(43 eyes) and Bottle BSS(42 eyes), on which phacoemulsification was performed through scleral tunnel incision followed by silicone PCL placement. Corneal endothelial cells were examined using specular microscopy postoperatively at 1 month and compared with preoperative specular microscopic data. RESULTS: The percent loss of corneal endothelial cell density at postoperative 1 month for the Bag BSS group(13.02+/-0.7%) was not significantly different from the Bottle BSS group(12.8+/-8.1%)(p>0.05). Coeffcient of variation in cell size(p>0.05) and mean endothelial cell size(p>0.05) also showed no significant difference between the two groups. CONCLUSION: In conclusion, Bag BSS and Bottle BSS have similiar protective effect on the corneal endothelial cell damage during phocoemulsification.
Cataract ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Humans ; Microscopy ; Phacoemulsification ; Plastics* ; Silicones

PURPOSE: The cornea of the keratoconus patient that is one of the contraindications in refractive surgery shows severe topographic asymmetry and the lower curvature is much steeper than the upper one. In this study, we evaluated whether the mild to moderate topographic asymmetry which does not fall under the Rabinowitz-McDonnell's keratoconus criteria(I-S value>3.0 D) would affect the LASIK results. METHODS: The maximal diopter difference in central 3 mm-zone(MDD-3) of the pre-LASIK topography, the postoperative best uncorrected visual acuity(UCVA) and the postoperative best corrected visual acuity(BCVA) were analyzed in 248 eyes of 124 patients retrospectively. We divided the patients into 2 groups according to the magnitude of MDD-3(MDD-3<1.0 D in group 1 and MDD-3> OR =1.0 D in group 2). In the same manner, the patients were divided into 2 groups according to the magnitude of MDD-5(MDD-5<1.0 D in group A and MDD-5> OR =1.0 D in group B) using 5 mm-zone. RESULTS: Between group 1 and 2, statistically significant difference was not observed in postoperative UCVA and BCVA(p>0.05). Between group A and B, statistically significant difference was not observed in postoperative UCVA and BCVA(p>0.05), either. CONCLUSIONS: This suggests that the mild pre-LASIK topographic asymmetry would not affect the visual acuity after LASIK.
Cornea ; Humans ; Keratoconus ; Keratomileusis, Laser In Situ* ; Refractive Surgical Procedures ; Retrospective Studies ; Visual Acuity