Myositis ossificans (MO) is a benign condition of non-neoplastic heterotopic bone formation in the muscle or soft tissue. Trauma plays a role in the development of MO, thus, non-traumatic MO is very rare. Although MO may occur anywhere in the body, it is rarely seen in the lumbosacral paravertebral muscle (PVM). Herein, we report a case of non-traumatic MO in the lumbosacral PVM. A 42-year-old man with no history of trauma was referred to our hospital for pain in the low back, left buttock, and left thigh. On physical examination, a slightly tender, hard, and fixed mass was palpated in the left lumbosacral PVM. Computed tomography showed a calcified mass within the left lumbosacral PVM. Magnetic resonance imaging (MRI) showed heterogeneous high signal intensity in T1- and T2-weighted image, and no enhancement of the mass was found in the postcontrast T1-weighted MRI. The lack of typical imaging features required an open biopsy, and MO was confirmed. MO should be considered in the differential diagnosis when the imaging findings show a mass involving PVM. When it is difficult to distinguish MO from soft tissue or bone malignancy by radiology, it is necessary to perform a biopsy to confirm the diagnosis.
Biopsy ; Buttocks ; Diagnosis, Differential ; Magnetic Resonance Imaging ; Muscles ; Myositis ; Myositis Ossificans ; Osteogenesis ; Physical Examination ; Thigh

PURPOSE: To determine the effects of provision of information on mother's problem focused coping ability during their child's intravenous procedure. METHODS: Data were collected from 56 mothers whose children have admitted to pediatric ward in the hospital. The participants included 27 intervention group mothers and 29 control group mothers. For the information intervention, "Programmed Information for Parental Coping before Intravenous Procedure (PIPC-IP)", video program was made based on self-regulation theory for the experimental group mothers. Mother's coping ability was measured by parental supportive behavior, parental beliefs and Profile of Mood State (POMS). RESULTS: Mothers who received PIPC-IP showed significantly higher levels of supportive behavior (t = 3.55, p = .005) and Parental Beliefs (t = 2.95, p = .005), but no significant difference in negative mood on POMS (t = .15, p = .87) compared to mothers in the control group. CONCLUSIONS: These results demonstrate that PIPC-IP is an effective intervention to increase the supportive behaviors and beliefs of mothers' problem focused coping ability but not the negative mood.
*Adaptation, Psychological ; Adult ; Attitude to Health ; *Child, Hospitalized/psychology ; Child, Preschool ; Double-Blind Method ; Emotions ; Female ; Health Education/*organization & administration ; Humans ; Infant ; Korea ; Male ; Mother-Child Relations ; *Mothers/education/psychology ; Nursing Evaluation Research ; *Phlebotomy/adverse effects/psychology ; Problem Solving ; *Programmed Instruction as Topic ; Psychological Theory ; Questionnaires ; Social Support ; Videotape Recording

BACKGROUND: Periodic lateralized epileptiform discharges (PLEDs) are associated with altered consciousness in 75% of patients. Major controversy about PLEDs is whether they are ictal or interictal phenomenon. Diagnosis of non-convulsive status epilepticus is often guided by response to benzodiazepine. We conducted a study to evaluate quantitative differences of EEG activity with PLEDs according to their response to acute benzodiazepine trial. METHODS: Nineteen patients with altered consciousness (stupor or coma) for whom the electroencephalography (EEG) recording with acute benzodiazepine trial was undertaken within 24 hours of onset of altered consciousness were retrospectively enrolled. Morphology of PLEDs including amplitude, frequency, and variability of the frequency was analyzed. Quantitative analysis of EEGs includes spectral power, spectral coherence, and graph theory analysis. Results of the analyses were compared between patients whose PLEDs were abolished by benzodiazepine (BDZ-R group) and those whose PLEDs persisted (BDZ-NR group). RESULTS: Morphologic variables were not different between two groups. In BDZ-R group, alpha-1 activity was increased in both frontopolar areas. Beta activity was also increased in both frontal areas while delta activity was reduced. In BDZ-R group, alpha-1 and beta activities were more coherent between bilateral hemispheres in frontal, anterior temporal, and central areas. Coherence line topographic map also revealed more bilaterally symmetric pattern in BDZ-R group. Network characteristics revealed by graph theory analysis did not differ between the two groups. CONCLUSIONS: Greater higher frequency activity (alpha-1 and beta) and lesser lower frequency activity (delta) in frontal areas, and more coherent activity in higher frequency band between hemispheres were associated with benzodiazepine responsiveness.
Benzodiazepines* ; Consciousness ; Diagnosis ; Electroencephalography* ; Humans ; Retrospective Studies ; Status Epilepticus ; Unconsciousness

The purpose of this study was to develop and evaluate psychometrically the Korean version of the Primary Care Posttraumatic Stress Disorder Screen for the Diagnostic and Statistical Manual-fifth edition (K-PC-PTSD-5). In total, 252 participants were interviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual-fifth edition-research version (SCID-5-RV). The K-PC-PTSD-5 showed good internal consistency (α = 0.872), test-retest reliability (r = 0.89), and concurrent validity (r = 0.81). A score of 3 was identified as the threshold for clinically significant posttraumatic stress disorder (PTSD) symptoms. Overall, the results indicate that the K-PC-PTSD-5 is a useful, timesaving instrument for screening PTSD symptoms.
Mass Screening* ; Primary Health Care* ; Reproducibility of Results ; Stress Disorders, Post-Traumatic*

Coronavirus disease 2019 (COVID-19) is one of the most widespread viral infections in human history. As a breakthrough against infection, vaccines have been developed to achieve herd immunity. Here, we report the first case of microscopic polyangiitis (MPA) following BNT162b2 vaccination in Korea. A 42-year-old man presented to the emergency room with general weakness, dyspnea, and edema after the second BNT162b2 vaccination. He had no medical history other than being treated for tuberculosis last year. Although his renal function was normal at last year, acute kidney injury was confirmed at the time of admission to the emergency room. His serum creatinine was 3.05 mg/dL. Routine urinalysis revealed proteinuria (3+) and hematuria. When additional tests were performed for suspected glomerulonephritis, the elevation of myeloperoxidase (MPO) antibody (38.6 IU/mL) was confirmed. Renal biopsy confirmed pauci-immune anti-neutrophil cytoplasmic antibody (ANCA)-related glomerulonephritis and MPA was diagnosed finally. As an induction therapy, a combination of glucocorticoid and rituximab was administered, and plasmapheresis was performed twice. He was discharged after the induction therapy and admitted to the outpatient clinic 34 days after induction therapy. During outpatient examination, his renal function had improved with serum creatinine 1.51 mg/dL. We suggest that MPA needs to be considered if patients have acute kidney injury, proteinuria, and hematuria after vaccination.

Objective: This study presents the reliability and validity of the Korean version of the post-traumatic stress disorder (PTSD) checklist for the Diagnostic and Statistical Manual for Mental Disorders-fifth edition (DSM-5) (K-PCL-5) and the short form (K-PCL-5-S). Methods: Seventy-one subjects with PTSD, 74 subjects with mood or anxiety disorders, and 99 healthy controls were enrolled. The Korean version of the Structured Clinical Interview for DSM-5-research version was used to confirm the presence of PTSD. The Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Impact of Event Scale-Revised (IES-R), and Spielberger State Trait Anxiety Inventory (STAI) were used to evaluate the concurrent validity of the K-PCL-5 and K-PCL-5-S. Results: It presented good internal consistency (Cronbach’s α=0.93) and test-retest reliability (r=0.90). The K-PCL-5 and K-PCL-5-S were highly correlated with the BDI-II, BAI, IES-R, STAI-S, and STAI-T. The suggested cutoff score for PTSD was 33 for the K-PCL-5 with a sensitivity of 88.51 and specificity of 89.09, and 6 for the K-PCL-5-S with a sensitivity of 91.95 and specificity of 89.09. The data were best explained with a one-factor model. Conclusion These results demonstrated the good reliability and validity of the K-PCL-5 and K-PCL-5-S, and their suitability as simple tools for PTSD assessment.

OBJECTIVE: Whether long-acting injectable antipsychotics (LAI) are superior to oral antipsychotics remains a controversial question, and results vary depending on the study design. Our study was performed to compare outcomes of oral anti-psychotics and paliperidone palmitate (PP) in clinical practice by investigating the numbers of admissions and bed days. METHODS: We performed a retrospective observational mirror-image study at a single medical center, reviewing medical charts to obtain the clinical data. Forty-six patients with a diagnosis of schizophrenia or schizoaffective disorder who had received at least two doses of PP were included in the analysis. The Wilcoxon signed-rank test was used to compare the numbers of bed days and admissions 1 year before starting PP with those numbers at 1 year after. RESULTS: The mean number of admissions fell from 0.83 to 0.17 per patient (p < 0.0002), and the median fell from 1 to 0. The mean number of bed days decreased significantly, from 24.85 to 8.74 days (p < 0.006). The outcomes remained similar in sensitivity analyses set up with different mirror points. CONCLUSION: Our results indicate that initiating PP reduced the mean numbers of hospital admissions and bed days compared with prior oral medication. LAIs may thus be cost effective in practice; its use bringing about cost reductions greater than its purchase cost.
Antipsychotic Agents ; Diagnosis ; Hospitalization ; Humans ; Paliperidone Palmitate ; Psychotic Disorders ; Retrospective Studies ; Schizophrenia

BACKGROUND: The purpose of this study was to localize the cortical regions reflected by overlying scalp electrodes. METHODS: We enrolled 10 patients with epilepsy (5 males, mean age 29.7 years old). Thin slice coronal T1 weighted MR images were obtained and then scalp EEG electrodes were placed based on an international 10-20 system. Cortical locations of scalp electrodes were determined using a real-time frameless stereotactic image guidance system, Brainsight(R). RESULTS: The locations of 19 scalp electrodes were marked on the 3D rendered cortical surface of one representative patient's MRI; Fp1 (Fp2) on the anterior pole of the middle frontal gyrus, Fz on the mid-point of the interhemispheric fissure in the frontal lobe, F3 (F4) on the mid-portion of the middle frontal gyrus, F7 (F8) on the pars triangularis of the inferior frontal gyrus, Cz on the interhemispheric fissure where a lateral precentral gyrus starts, C3 (C4) scattered around postcentral gyrus, T3 (T4) on the middle temporal gyrus, P3 (P4) on the angular gyrus, Pz on the mid-point of the interhemispheric fissure in the parietal lobe, T5 (T6) on the posterior part of the inferior temporal gyrus, and O1 (O2) on the occipital pole. CONCLUSIONS: The locations of scalp electrodes were well correlated with conventional concepts of their cortical locations. The individual differences of the scalp electrode locations may be due to the different sizes and morphologies of the brains in each of the patients. Real time cortical localization of scalp electrodes using the Frameless Stereotactic Image Guidance System may provide useful information for more accurate localization of focal cerebral activity in partial epilepsy patients.
Brain* ; Electrodes* ; Electroencephalography ; Epilepsies, Partial ; Epilepsy ; Frontal Lobe ; Humans ; Individuality ; Magnetic Resonance Imaging ; Male ; Neuronavigation ; Parietal Lobe ; Scalp*

In determination of brain death, brain CT angiography (CTA) can be used as a new ancillary test to assist EEG which is the current gold standard. We report a patient with barbiturate coma therapy whose CTA showed weak filling of the internal carotid artery and its branches when his EEG demonstrated regional beta activities in the corresponding area, which finally disappeared. Combined use of CTA and serial EEGs would be helpful as brain death testing in a patient with barbiturate coma therapy.
Angiography* ; Brain Death* ; Brain* ; Carotid Artery, Internal ; Coma* ; Electroencephalography ; Humans ; Pentobarbital ; Subarachnoid Hemorrhage*

BACKGROUND: For diagnosis of post-traumatic stress disorder (PTSD), the Clinician-Administered PTSD Scale (CAPS) is one of the most widely used structured diagnostic interviews. METHODS: In this study, we aimed to develop and validate the Korean version of CAPS for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition ([DSM-5] K-CAPS-5). Seventy-one subjects with PTSD, 74 with mood disorder or anxiety disorder, and 99 as healthy controls were enrolled. The Korean version of the structured clinical interview for DSM-5-research version was used to assess the convergent validity of K-CAPS-5. BDI-II, BAI, IES-R, and STAI was used to evaluate the concurrent validity. RESULTS: All subjects completed various psychometric assessments including K-CAPS-5. K-CAPS-5 presented good internal consistency (Cronbach's α = 0.92) and test-retest reliability (r = 0.91). K-CAPS-5 showed strong correlations with the structured clinical interview for DSM-5 PTSD (k = 0.893). Among the three subject groups listed above there were significant differences in the K-CAPS-5 total score. The data were best explained by a six-factor model. CONCLUSION: These results demonstrated the good reliability and validity of K-CAPS-5 and its suitability for use as a simple but structured instrument for PTSD assessment.
Anxiety Disorders ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Mood Disorders ; Psychometrics ; Reproducibility of Results ; Stress Disorders, Post-Traumatic