Transient global amnesia(TGA) is not a rare event in the elderly, which is characterized by transient inability to form the new memory traces plus retrograde amnesia with benign prognosis. The etiology is unknown, but suggested causes have included transient ischemic attack, migraine, epilepsy, brain tumor, drug intoxication, other toxic/metabolic disturbances, or hysteria. Especially, TGA associated with ischemic stroke is important on the elderly patients and necessary to be differentiated with other causes, for stroke prevention. As far as we know, the case of TGA due to cerebral infarction confirmed by brain imaging study is extremely rare in the literature. We report the case of 67 year-old female patient with typical TGA showing ischemic lesion on the right temporal area on MRI and discussed its significance as one of the cause of TGA.
Aged ; Amnesia, Retrograde ; Amnesia, Transient Global* ; Brain Neoplasms ; Cerebral Infarction ; Epilepsy ; Female ; Humans ; Hysteria ; Infarction* ; Ischemic Attack, Transient ; Magnetic Resonance Imaging ; Memory ; Migraine Disorders ; Neuroimaging ; Prognosis ; Stroke

Objectives: This qualitative study explores the perspectives of dental hygienists and examines factors influencing payment structures in a community home-based oral health care intervention program. Methods: Focus group interviews were conducted on October 26, 2023, in a quiet study room over 120 minutes. Intervention providers who participated in the older adults medical care integration support program were included in this study. Their ages ranged from 25 to 57 years, with experience in home-based oral healthcare spanning from 1.5 to 5 years. Voice recordings of the interviews were transcribed using Clova Note and Naver’s AI transcription tool. Subsequently, the ‘Word Cloud Generator 3.7’ program was employed to extract, visualize, and analyze frequently mentioned words and key concepts from the responses. Results Semantic analysis identified 61 significant keywords and 10 subcategories, categorized into four main themes: ‘oral health challenges in the elderly,’ ‘work system of home-based dental hygienists,’ ‘needs and realities of home-based oral care,’ and ‘payment and compensation frameworks.’ Conclusions: To address the demands of a super-aging society, it is imperative to establish a standardized oral healthcare cost system for home-based interventions, supported by clear laws and regulations.

Objectives: This qualitative study explores the perspectives of dental hygienists and examines factors influencing payment structures in a community home-based oral health care intervention program. Methods: Focus group interviews were conducted on October 26, 2023, in a quiet study room over 120 minutes. Intervention providers who participated in the older adults medical care integration support program were included in this study. Their ages ranged from 25 to 57 years, with experience in home-based oral healthcare spanning from 1.5 to 5 years. Voice recordings of the interviews were transcribed using Clova Note and Naver’s AI transcription tool. Subsequently, the ‘Word Cloud Generator 3.7’ program was employed to extract, visualize, and analyze frequently mentioned words and key concepts from the responses. Results Semantic analysis identified 61 significant keywords and 10 subcategories, categorized into four main themes: ‘oral health challenges in the elderly,’ ‘work system of home-based dental hygienists,’ ‘needs and realities of home-based oral care,’ and ‘payment and compensation frameworks.’ Conclusions: To address the demands of a super-aging society, it is imperative to establish a standardized oral healthcare cost system for home-based interventions, supported by clear laws and regulations.

Objectives: This qualitative study explores the perspectives of dental hygienists and examines factors influencing payment structures in a community home-based oral health care intervention program. Methods: Focus group interviews were conducted on October 26, 2023, in a quiet study room over 120 minutes. Intervention providers who participated in the older adults medical care integration support program were included in this study. Their ages ranged from 25 to 57 years, with experience in home-based oral healthcare spanning from 1.5 to 5 years. Voice recordings of the interviews were transcribed using Clova Note and Naver’s AI transcription tool. Subsequently, the ‘Word Cloud Generator 3.7’ program was employed to extract, visualize, and analyze frequently mentioned words and key concepts from the responses. Results Semantic analysis identified 61 significant keywords and 10 subcategories, categorized into four main themes: ‘oral health challenges in the elderly,’ ‘work system of home-based dental hygienists,’ ‘needs and realities of home-based oral care,’ and ‘payment and compensation frameworks.’ Conclusions: To address the demands of a super-aging society, it is imperative to establish a standardized oral healthcare cost system for home-based interventions, supported by clear laws and regulations.

Objectives: This qualitative study explores the perspectives of dental hygienists and examines factors influencing payment structures in a community home-based oral health care intervention program. Methods: Focus group interviews were conducted on October 26, 2023, in a quiet study room over 120 minutes. Intervention providers who participated in the older adults medical care integration support program were included in this study. Their ages ranged from 25 to 57 years, with experience in home-based oral healthcare spanning from 1.5 to 5 years. Voice recordings of the interviews were transcribed using Clova Note and Naver’s AI transcription tool. Subsequently, the ‘Word Cloud Generator 3.7’ program was employed to extract, visualize, and analyze frequently mentioned words and key concepts from the responses. Results Semantic analysis identified 61 significant keywords and 10 subcategories, categorized into four main themes: ‘oral health challenges in the elderly,’ ‘work system of home-based dental hygienists,’ ‘needs and realities of home-based oral care,’ and ‘payment and compensation frameworks.’ Conclusions: To address the demands of a super-aging society, it is imperative to establish a standardized oral healthcare cost system for home-based interventions, supported by clear laws and regulations.

Brainstem lesions may produce a cheiro-oral syndrome infrequently. The cheiro-oral syndrome in pontine lesion is due to involvement of ventral trigeminothalamic tract and the medial part of the medial lemniscus. The cheiro-oral syndrome rarely associates with internuclear ophthalmoplegia. A 58-year-old hypertensive man complained of dizziness, diplopia, and dysesthesia in the right hand and ipsilateral perioral region. On neurologic examination, there was left internuclear ophthalmoplegia. Others were unremarkable. Brain MRI demonstrated a small round lesion in the paramedian tegmentum of the left upper pons and lower midbrain, which involved ventral trigeminothalamic tract, medial part of medial lemniscus and medial longitudinal fasciculus. We report a case of brainstem infarction with a rare combination of cheiro-oral syndrome and internuclear ophthalmoplegia.
Brain ; Brain Stem Infarctions* ; Brain Stem* ; Diplopia ; Dizziness ; Hand ; Humans ; Magnetic Resonance Imaging ; Mesencephalon ; Middle Aged ; Neurologic Examination ; Ocular Motility Disorders ; Paresthesia ; Pons

PURPOSE: To develop a patient self-completed questionnaire from the items of the Brief Core Set Questionnaire for Breast Cancer (BCSQ-BC) and to investigate the prevalence of specific dysfunctions throughout the course of cancer and treatments. METHODS: From January 2010 to February 2011, 96 breast cancer patients were evaluated with BCSQ-BC developed for clinical application of International Classification of Functioning, Disability and Health (ICF). Quality of life and upper limb dysfunction using disabilities of arm, shoulder and hand (DASH) were assessed. Content validity was evaluated using correlations between BCSQ-BC and European Organization for Research and Treatment of Cancer (EORTC) QLQ and DASH scores. Construct validity was computed using exploratory factor analysis. Kappa statistics were computed for agreement between test-retest ICF data. The level of significance and odds ratios were reported for individuals with early post-acute and long-term context and with total mastectomy and breast conservative surgery. RESULTS: There was consistently good test-retest agreement in patient-completed questionnaires (kappa value, 0.76). Body function, activity and participation subscales are significantly related with EORTC QLQ and DASH. Problems with activity and participation were strongly associated with physical functional domains of EORTC QLQ (r=-0.708, p<0.001) and DASH (r=0.761, p<0.001). The prevalence of dysfunctions varied with type of surgery and time after cancer. Immobility of joint (15% vs. 7%) and lymphatic dysfunction (17% vs. 3%) were indexed more frequently in extensive surgery cases than in conservative surgery. Muscle power (16% vs. 8%), exercise tolerance functions (12% vs. 4%) and looking after one's health (10% vs. 2%) were impaired within 1 year after surgery, while sleep dysfunction (8% vs. 14%) was a major problem over 1 year after surgery. CONCLUSION: The BCSQ-BC identifies the problems comprehensively in functioning of patients with breast cancer. We revealed the interaction with the ICF framework adopting a multifactor understanding of function and disability.
Arm ; Breast ; Breast Neoplasms ; Exercise Tolerance ; Hand ; Humans ; Joints ; Mastectomy, Simple ; Muscles ; Odds Ratio ; Prevalence ; Quality of Life ; Shoulder ; Survivors ; Upper Extremity ; Surveys and Questionnaires

PURPOSE: To develop a patient self-completed questionnaire from the items of the Brief Core Set Questionnaire for Breast Cancer (BCSQ-BC) and to investigate the prevalence of specific dysfunctions throughout the course of cancer and treatments. METHODS: From January 2010 to February 2011, 96 breast cancer patients were evaluated with BCSQ-BC developed for clinical application of International Classification of Functioning, Disability and Health (ICF). Quality of life and upper limb dysfunction using disabilities of arm, shoulder and hand (DASH) were assessed. Content validity was evaluated using correlations between BCSQ-BC and European Organization for Research and Treatment of Cancer (EORTC) QLQ and DASH scores. Construct validity was computed using exploratory factor analysis. Kappa statistics were computed for agreement between test-retest ICF data. The level of significance and odds ratios were reported for individuals with early post-acute and long-term context and with total mastectomy and breast conservative surgery. RESULTS: There was consistently good test-retest agreement in patient-completed questionnaires (kappa value, 0.76). Body function, activity and participation subscales are significantly related with EORTC QLQ and DASH. Problems with activity and participation were strongly associated with physical functional domains of EORTC QLQ (r=-0.708, p<0.001) and DASH (r=0.761, p<0.001). The prevalence of dysfunctions varied with type of surgery and time after cancer. Immobility of joint (15% vs. 7%) and lymphatic dysfunction (17% vs. 3%) were indexed more frequently in extensive surgery cases than in conservative surgery. Muscle power (16% vs. 8%), exercise tolerance functions (12% vs. 4%) and looking after one's health (10% vs. 2%) were impaired within 1 year after surgery, while sleep dysfunction (8% vs. 14%) was a major problem over 1 year after surgery. CONCLUSION: The BCSQ-BC identifies the problems comprehensively in functioning of patients with breast cancer. We revealed the interaction with the ICF framework adopting a multifactor understanding of function and disability.
Arm ; Breast ; Breast Neoplasms ; Exercise Tolerance ; Hand ; Humans ; Joints ; Mastectomy, Simple ; Muscles ; Odds Ratio ; Prevalence ; Quality of Life ; Shoulder ; Survivors ; Upper Extremity ; Surveys and Questionnaires

PURPOSE: We compared the results of arthroscopic Bankart repair using metal and biodegradable anchor fixation. MATERIALS & METHODS: We reviewed 26 patients with anterior shoulder instability treated by arthroscopic Bankart repair from October, 2006, to March, 2007, 15 patients with metal anchors and 11 patients with biodegradable anchors. The average age was 27.4 years old (range: 17~55) and mean follow-up was 14 months (range: 12~17 months). Functional outcome was evaluated using the Korean Shoulder Score for Instability (KSSI), Rowe's Bankart Grading scale (RBGS), ASES score, and UCLA scores. RESULTS: In the metal-anchor group, the improvements of mean KSSI, ASES, UCLA score, and RBGS were 20.6, 24.0, 4.0, and 45.5, respectively. In the biodegradable anchor group, improvements of mean KSSI, ASES, UCLA score, and RBGS were 21.0, 23.6, 4.6, and 48.9. The improvements in final outcomes were not significantly different (p>.05). One metal problem and one traumatic redislocation occurred in the metal group. CONCLUSION: Both techniques produced satisfactory outcomes in the treatment of traumatic anterior instability. The biodegradable anchor group could also avoid problems with metal anchors.
Follow-Up Studies ; Humans ; Shoulder

A factor VII gene -401 G/A polymorphism was identified in a patient with a pulmonary embolism. The patient was a 71-year-old woman who presented with acute-onset dyspnea. A chest CT scan revealed a pulmonary embolism. Despite the administration of low-dose warfarin as anticoagulation therapy, there was an excessively prolonged prothrombin time (PT). The blood tests revealed lower factor VII activity than normal. Full factor VII gene sequencing revealed a G to A substitution at ?401 in the promoter region. There were no other gene sequence anomalies. PCR-based analysis indicated lower factor VII gene expression in the patient than in a control subject. The data suggested the promoter polymorphism to be responsible for the lower transcription level. In conclusion, we encountered a case of Factor VII DNA polymorphism in a patient with a pulmonary embolism showing significantly reduced Factor VII activity.
Aged ; DNA ; Dyspnea ; Factor VII ; Female ; Gene Expression ; Hematologic Tests ; Humans ; Polymorphism, Genetic ; Promoter Regions, Genetic ; Prothrombin Time ; Pulmonary Embolism ; Thorax ; Warfarin